There is an endless number of items, toys, games, and therapy equipment I would love to have, but like most people, space, money, and time are always a barrier.  I use to use a sensory tunnel during treatments when I worked in the clinic setting and it was a favorite of many of the kiddos I worked with.  I was inspired last week by one family I work with to copy their stretchy sensory tunnel and make my own.


A sensory tunnel can be used as a “heavy work” activity to help our proprioceptive input.  Proprioception is knowing where our body is in space.  Our muscles, joints, tendons, and connective tissue sends signals to our brain telling us where our body is in relation to other objects or people.  Since the sensory tunnel lays tight around the kiddo’s body as they crawl through, it provides a lot of proprioceptive input, as well as tactile input.

A sensory tunnel is made of stretchy material like Spandex or Lycra.  I found some Spandex material at our local JoAnn Fabric.  I have heard of others finding stretchy material on the clearance rack for as low as $1.oo per yard!  {I was not so lucky, but was able to use a 40% off coupon}.  I was told by a lady at a fabric store that polyester thread would be the most durable thread to use.  I also found some elastic thread, but we did not end up using it.   I do not have a sewing machine, so I went to my amazing mother’s house and she helped me make the tunnel. Here are the steps to making your own sensory tunnel:

  1. Buy 3-4 yards of stretchy material (such as Spandex)
  2. Fold your fabric in half long ways with the material inside out
  3. You may pin the fabric together, but we found that we were able to pin just the first 6 inches or so and then held it together with our hands and the foot on the sewing machine
  4. Determine how big you want the opening of your tunnel and sew length-wise down the entire length of fabric (I recommend approximately 20-30 inches in diameter – mine pictured is approx.. 25 inches)
  5. Trim any excess fabric
  6. Turn right side out
  7. Ta-Da! Tunnel complete!

DIY Sensory Tunnel  DIY Sensory Tunnel

We did not hem the ends of the fabric since we used Spandex which so far, doesn’t seem to fray.  Other material may need a hem.

To use your tunnel, hold one end of the tunnel open to help your child crawl through to the other end.  If your child is a little nervous to go inside, you may have a second person hold the other end so that they can see all the way through.  You could hide toys or stuffed animals inside for them to find or have them push a therapy ball through the tunnel for even more resistance.  Frequently, I have kids crawl through to retrieve puzzle pieces and put a puzzle together on the other side.

What other activities could you use for your tunnel?  Have you seen any good deals on fabric?  Let me know how your tunnel making experience goes!  


The purpose of this blog is to provide resources for parents who want to carry over therapy activities with their child at home.  The information provided here does not replace therapy or medical care provided by a qualified therapist or medical professional.    These activities are safe for most children.  However, some activities or materials may be inadvisable for children who have certain allergies or medical conditions.  It is recommended that you consult your child’s medical provider or therapist before engaging in the activities you have selected.  

I have recently been introduced to SNAC – Special Needs Advocacy Coalition, which is a community network in Mohave County dedicated to  supporting and assisting in the collaboration of special needs services, such as; resource sharing, building community awareness, and education.


SNAC coordinates a support group for families in each of our three main cities (Kingman, Bullhead City, and Lake Havasu City) to have discussions and trainings for parents and caregivers of individuals with special needs.  Click here for the meeting dates and times.

SNAC has also played an integral roll in working to identify how to best help those with special needs in our communities.  The Mohave County Department of Public Health as part of the Health in Arizona Policies Initiative has developed four surveys to identify the needs and gaps in services from families and providers of children and youth with special healthcare needs in Mohave County.  Please help them out by clicking on the survey that best fits you and completing it:

Parent-Caregiver Survey

Youth Survey (ages 14-22, but a Parent Consent is required for ages 14-17)

Healthcare Provider Survey

Teacher Survey

I have attached below an Introductory Letter for the survey (Survey Introduction Letter (2)).  Please pass this along to any family, friends, parents, coworker, fellow providers, etc.  They are hoping to be able to determine the needs of our community, such as special needs playgrounds, etc.

What other resources do you know about in our area?  Please comment to share with other families and healthcare providers.


The purpose of this blog is to provide resources for parents who want to carry over therapy activities with their child at home. The information provided here does not replace therapy or medical care provided by a qualified therapist or medical professional.
These activities are safe for most children. However, some activities or materials may be inadvisable for children who have certain allergies or medical conditions. It is recommended that you consult your child’s medical provider or therapist before engaging in the activities you have selected.

Let’s Talk About Toes

April 17, 2014 — 5 Comments

This is a guest post by Shannon Kinne, a student physical therapist assistant who is on her last clinical rotation with me.  Enjoy her blog on Toe Walking and comment below on your thoughts and ideas about Toe Walking.  A special thanks goes out to her adorable niece, Madison!  Thanks for being our model!

Toe walking in children can be normal as a child is developing from infant to toddler.  Developing children up through approximately age three can have the inability to strike first with their heel during their gait cycle (medical term for “walking”) as they learn to walk.  You may have seen older children still walking on their toes.  There is not one solid answer for this; therefore, it is important to look into the reasons that may contribute to toe-walking.

Toe Walking

It is important to know that even if a child continues to keep walking on their toes as they get older, it does not mean they have an underlying serious condition.  Children older than three who do not show signs of neurological, orthopedic or psychiatric disorders may walk on their toes due to generalized stiffness of connective tissue, muscle weakness, nerve related issues or a mixture of them.  The main cause for concern in these cases would be muscle soreness, tightening and pain in the calf and in their Achilles tendon.  Constant shortening of the Achilles tendon and/or gastrocnemius and soleus muscles (calf muscles) could turn into contractures (shortening and hardening of a muscle) if left untreated.

Treatments for these types of conditions can depend on the severity of the problem.  Physical therapy and even at home stretching can help to re-train a muscle and assist them into a more normal walking pattern.  Some fun stretches for kids could be animal walks.  For example; ask your child to do a “bear walk” across the room by coming up onto all four extremities, and attempting to keep their heels pushed down towards the floor as they walk.  You can see the stretch they will achieve as this also puts the child’s foot into a more flexed position.  In more severe cases, a child may require casting or splinting to keep the ankle in a more neutral position allowing a constant stretch and re-training of the muscles.  Surgery has also been an option for some children when lengthening of the tendons and muscles are required.

Madison's Bear Walk Position

In some cases, toe walking can be the result of a neurological disorder.   Often they continue to have full range of motion in their ankle; however, they may be experiencing some form of developmental delay.  There seems to be a high incidence of toe walking with children who may have cognitive or mental disorders.  Children with autism often experience sensory issues in which the brain does not receive feedback telling the body which motion they are performing or position they are in.   Cerebral Palsy and Muscular Dystrophy are other known neurological disorders to cause a child to walk on their toes.  Cerebral palsy is caused by a brain injury or brain abnormality which can affect the body’s control of muscle tone, strength and coordination.  Increased tone or spasticity in a muscle does not allow relaxation of the extremities which can cause the child to come up onto their toes.  With muscular dystrophy, this rare disease causes muscle fibers to break down and muscle weakness which can attribute to the toe walking, and can be one of the early signs and symptoms as they begin to walk.

How do you think toe walking can affect a child in the long run?  What ideas do you have to incorporate “fun play” into the process of rehabilitation?



Engelbert R, Gorter J, Uiterwaal C, van de Putte E, Helders P. Idiopathic toe-walking in children, adolescents and young adults: a matter of local or generalised stiffness?. BMC Musculoskeletal Disorders [serial online]. March 21, 2011;12:61.

Anderson, J. M. (2011). Idiopathic Toe Walking. Cincinnati Childrens Hospital Medical Center, 1-17.

Childrens Hospital of Wisconsin. (2014). Muscular Dystrophy. Childrens Hospital of Wisconsin.

Nair, D. (2013). Toe-Walking in Children Could be Sign of Developmental Delay. Mental Health: Counsel & Heal.

Stephen M Edelson, P. (2014). Toe Walking. Autism Research Institute.


The purpose of this blog is to provide resources for parents who want to carry over therapy activities with their child at home. The information provided here does not replace therapy or medical care provided by a qualified therapist or medical professional.
These activities are safe for most children. However, some activities or materials may be inadvisable for children who have certain allergies or medical conditions. It is recommended that you consult your child’s medical provider or therapist before engaging in the activities you have selected.

First Things First is hosting the 3rd Annual Northwest Arizona Symposium scheduled for March 31- April 1, 2014 in Laughlin, Nevada at the Aquarius Resort, Casino.  Go here for more information and the flyers about the event.

Let me know if you will be going!

I just found out about a great event that is being put on in Lake Havasu City by Special People Like You.  The 1st Annual Exceptional Rodeo will take place on Saturday March 8th, 2014 from 10:00am to 4:00pm at Sara Park Fairgrounds.  Here is the information from their flyer:

“The mission of the Special People Like You Exceptional Rodeo is to provide an annual fun filled day of Western / Rodeo-like activities and entertainment for mentally and/or physically challenged people and their families that they otherwise would not be able to experience. We go out of our way to instill in each person a sense of belonging and the belief that they are special each one in their own way.

Each pre-registered participant will get an event T-Shirt, a participation back number and other goodies as a memento of a great day. They will be able to encounter horses, and depending on their capabilities, ride or sit on one, and play lots of other rodeo games on the ground, such as racing around a barrel and pole mini pattern in their wheelchairs or on stick horses, take part in dummy cow roping, get their faces painted, meet a Rodeo Clown, participate in art and crafts activities making pipe-cleaner horses, and much more. Get a picture taken with the 2013 Special People Like You Rodeo Queen and a real cowboy.

Free popcorn and water/soft drinks will be provided to all participants and volunteers. This event is 100% free for these special people and their families.

Register early to secure your event T-Shirt (no later than February 14th 2014) either by phone, call Maria Boody at 928-208-5842 or via email to    See you there!

UPDATE – January 31st, 2014

Seems like we are also going to have a donkey at the event.

Also, the Pet Partners will be there with a booth and several of their sweet dogs to meet and love on.

We will have a Raffle at the rodeo with lots of cool prizes and giveaways! You can purchase your raffle tickets ahead of time or at the event, one for $ 1, 6 for $ 5 or 13 for $ 10.

Several food vendors will be at the event.” 

All these details and more can be found on their website at

Kraft Cheese Recall

October 29, 2013 — Leave a comment

Hello all!

I came across this and thought I would spread the word. Kraft has issued a recall on their Kraft and Polly-O String Cheese and String Cheese Twists due to premature spoilage.  Click here for the news release from Kraft.  Check it out, it lists all the products involved and what to do if you purchased these.  Stay healthy and have a great day!

I had a close friend of mine (who is a PT also, primarily works with adults) contact me the other day asking, “Tricia, how do convince a 10-year-old to do exercises?” Now there’s a question! Kids can be very motivated . . . for what they want to do, not necessarily what any adult wants them to do. The said adult could be their parent, grandparent, therapist, teacher, babysitter, etc.


I have learned a couple tricks to get the results I need out of children. These ideas are of course age-sensitive, as well as maturity-sensitive.

If the child is a teenager, or at least wants to be older, I always try to pull the athlete talk. I ask them what sports they are interested in. Once they have told me their sport of interest, I tell them that in order to be the best athlete they can be, it is mandatory to exercise to create a strong core, desired flexibility, hand-eye coordination, etc. I tell them that all athletes, whether high school, college or professional, exercise and train regularly. I’ve had several kids, that as long as I remind them of this every now and then, it keeps them fairly motivated.

Of course, the sport talk sometimes only goes so far. I frequently incorporate an obstacle course or game into my exercises. Games with pieces, such as Jenga, Connect 4, Checkers, etc. work great to have your child use stairs, or a stepper (on a stepper, you could do forward steps, backward steps, or side steps), walk along a balance beam (a 2×4 board works good for this), or heel raises to reach up high for each game piece.

With a game like Candy Land, I will place the cards across the room and have the child do animal walks to pick each card. Animal walks can include penguin walks (walking on heels), frog jumps (squat jumps), crab walks (hands and feet with stomach facing the ceiling), inch worm (on hands and feet with stomach down, walk hands out first to lengthen body, then walk feet to hands to shorten body), bear walks (walk on hands and feet with stomach facing floor), duck walks (“walking” in squatted position), tip toe quiet like a mouse, or jumping like a bunny.

Kyler Balance Beam

If you are working on an exercise that requires multiple sets of 10, you could have your child perform 10 sets of the exercise (straight leg raises, bridges, hamstring curls, etc.), then they can take their turn with a game, or blowing bubbles, or whatever activity they enjoy doing. Then repeat.

One trick, I mean “idea”, is to not call them exercises. When it’s time for exercising, say, “Let’s play a game!” Or call it something that encourages your child – basketball training, animal tricks, etc. One of my kiddos always says when therapy is over, “Thank you for dancing with me today!” (even though we may not have “danced”). 😉

These ideas should jump start your child’s exercise routine.

What have you done to encourage your child to perform exercises? Share your ideas in the comments below. You never know, your idea may help another parent or therapist!

The purpose of this blog is to provide resources for parents who want to carry over therapy activities with their child at home. The information provided here does not replace therapy or medical care provided by a qualified therapist or medical professional.
These activities are safe for most children. However, some activities or materials may be inadvisable for children who have certain allergies or medical conditions. It is recommended that you consult your child’s medical provider or therapist before engaging in the activities you have selected.

I have parents ask me multiple times per week, “What are the best toys to buy for my child?” This was a question I frequently asked when I first started treating children as well.

When I was taking my NDT Certification Course, I wanted to explore all my instructors’ “suitcases of toys”. They always had the coolest gadgets to entertain the kids. Most of us would have at least 5+ activities or toys lined up because kids have pretty short attention spans, as we all know (especially those who have kids themselves). The instructors, on the other hand, could keep a child engaged for an entire hour session with just 1 small toy! I was always mesmerized by this and still to this day am always on the search for the perfect toys!

Of course it depends on the age of the child, but the following are 3 of my favorite toys (currently):

1. Flying Monkey

Flying Monkey

All of my kids LOVE the flying monkey! – I found this odd little toy being sold from a box at the register of a local gas station. This little monkey has stretchy arms and pockets on his hands where you place your fingers . . . pull back his feet and tail and off he flies across the room (of course with his super hero cape fluttering behind him). Once he lands, he makes loud monkey sounds (enter monkey screaming here). I use him to knock over towers we have built, to land in a bucket (add this to my previous bucket blog), or simply to walk across an obstacle course I’ve built.

2. Connect 4

Connect 4

This classic game I have found to be so handy to work on fine motor skills (pincher fingers), reaching up high to work on sitting or standing up tall (to place game piece in), to work on sit to stand (grab piece from floor, then stand to table to drop piece into game), trunk/back strength when played lying on belly and having to reach forward and up to place piece in game, etc. I use this with my older kids and my younger kids. My younger kids may not play the traditional game, but they love to fill it up and slide to watch them all crash down.

3. Bead Necklaces

Beads with Reacher

Cheap bead necklaces that you buy for parties are always a blast! With little girls, of course the obvious dress up always entertains. Boys like to use them as pirate treasure. I frequently use the beads to provide tactile input – I will roll the beads along a body part (the feet for example) when a child does not have a lot of body awareness of their feet. The child feels the beads on his feet and then I may have him reach with his feet to roll the beads toward him. I have used reachers to have the kids pick up the beads. They are perfect for working on reaching tasks to put a necklace on mom or on a doll.Beads with Lucy Doll

These are usually standard toys that you will always find at the bottom of my bag of tricks.

What are your favorite toys that keep kids motivated? Please share below in the comments. Thanks and have a great day!

What’s in a Bucket?

March 5, 2013 — 1 Comment

Everyone thinks you have to buy the most expensive, elaborate toys out there to provide well for your children.  I disagree.

What's in a bucket?

What’s in a bucket?

I think having a few strategic classics will provide endless opportunities for imagination, learning, creativity, and fun!  Today’s pick: a bucket!  Buckets come in all shapes, sizes, and colors, with handles, without handles, there are so many to choose from.  And what house doesn’t have a bucket?  If you don’t think you have one, look closer.  Mom’s Tupperware drawer is a good place to start.  The cabinet of pots have many sized “buckets”.  And dad’s garage must have a can or bucket of some sort that could be shared.  Here are the activities I have used with buckets, baskets, barrels, pots, and containers.

  • Throw a ball or bean bags into a bucket.  Or even better, play basketball!  To incorporate your child’s therapy goals into her play, have her stand on a “mountain” (aka: pillow, piles of blankets, sofa cushions, etc.) to challenge her balance while playing ball.  This can also be used to practice her catching.  You can stand by the bucket and toss her back the ball or bean bag.
  • Make “soup” in your bucket with play food or animals placed on other side of room.  I frequently have kids walk through an obstacle course for my bean bag frogs to make “froggy soup” and then we “stir” it up with a stick or dowel (or a pretend spoon if there is nothing else available).
  • What young child doesn’t love the anticipation of dropping a marble down a spiraled pop tube or even a paper towel tube?  It’s a great cause and effect learning tool waiting for the marble to hit the bottom of the bucket.  To slip in his therapy goals, have him reach way up high to grasp the marble or to put in the pop tube to encourage extending his back.  Or if he is working on strengthening his legs, have him reach up high onto his tippy toes for each marble.Buckets 021
  • If you have multiple buckets, you could stack them up, have action figures hiding inside and launch the flying monkey or roll a ball at it to knock them all over.  I have some kiddos I treat who will do anything to make something crash!
  • Play dress up!  Use a bucket as a top hat, or a purse, or a construction bucket of tools.  Your child’s imagination will take him on all kinds of adventures!
  • Go outside and play!  Take that bucket outside with a shovel or wooden spoon and dig, dig, dig!  Take it to the beach and make a sand castle, or collect sea shells!  Use the bucket to sneak up on someone and pour water on them on a hot summer day!
  • Help dad in the garage!  I know as a kid, my brother and I loved to hang out in the garage with Dad.  He would give us little projects, like sorting his nails, screws, and bolts.  Doesn’t sound like too much fun to us adults, but to kids, they love to explore the grown up world.  Have your kiddo sort anything into buckets or cans, whether it is nuts and bolts, beads, macaroni, beans, etc.

That’s just with a bucket!  Imagine what your kids can come up with.

What activities have you used with a bucket?  What are your kids’ favorites?  Comment to share!  And as always, have a great day!

“You are going to do this in my home?” Why yes, yes I am! I am now providing physical therapy services to children in their homes and communities! I am so excited about this adventure! There are so many benefits to having home-based therapy services and here are the top 10 benefits of having therapy at home:Kyler03

  1. Convenience! Your therapist comes to you, so you don’t have to round-up all the kids, pack them in the car, drive across town (or the vast desert in our case), and sit in a waiting room. He or she comes right to your door in the convenience of your home.
  2. What we do in therapy can be done at home! So many times in the clinic, parents think, “Well that’s wonderful you can get him to do {enter gross motor skill or task} here in the clinic, but how can I get him to do that at home?” The “clinic” now is your home, so your therapist can help you help your child succeed at doing {enter gross motor skill or task} inside your home. Your therapist will utilize what you have around the house to make you and your child succeed!
  3. Privacy! You won’t have to worry about running into that nosey co-worker in the parking lot wondering what you are here for. In the privacy of your home, only those you are closest to will be present for your child’s treatment.
  4. Motivating! You and your family can all be cheerleaders for success. Even the family dog can be used as a motivator during therapy sessions.
  5. Functional! If there is a particular task your child is having problems with at home, you can show your therapist exactly what that task is. Maybe she has trouble climbing into her bed . . . well, she can work on it in the real-life environment of her bedroom!
  6. Comfort! Many children may become nervous about going into a medical clinic because they associate it with getting shots at the doctor. Not so when the therapist comes to the home. Your therapist will be on your child’s turf instead of the other way around.
  7. Everyone can be involved! The entire family is welcome and encouraged to join in during therapy sessions. It makes it more motivating and natural when siblings are there to play with, or grandma can help with an activity.
  8. Community! Not only can you have therapy sessions at home, but in the community as well. Maybe the stairs going up into church are cumbersome . . . well let’s meet at church so your kiddo can work on that goal. Or your kiddo has trouble going down the slide on the playground . . . let’s meet at the park. There are endless opportunities: bowling alley, hiking trails, beach, school, grandpa’s house, etc.
  9. Collaboration! Does your child need new orthotics (braces)? Or a new wheelchair? Your therapist can meet you at the orthotist’s office, or help the wheelchair supplier with measurements and customization of your kiddo’s new wheelchair. It is very beneficial to have your health care providers work hand-in-hand!
  10. Safety and Health! Being in the comfort and safety of your home is vital for children who are chronically ill and fragile. When your therapist meets at your home, your child is not exposed to the germs of everyone who has been in the clinic waiting room. He or she is also not exposed to the extreme temperatures outside or the wind and allergens in the air during transport.

What benefits do you see with having therapy in your home? What locations in the community would be the most fun to meet for therapy? Comment your ideas! I would love to hear them!