Tag Archive | physical therapy

Win, lose, or draw?

As the school year winds down, many kids’ activity levels (thankfully) start to ramp up.  With end-of-the-year field days and the beginning of summer ball, my Facebook news feed is exploding with comments and articles expressing a similar sentiment:

Remember when there were actually winners and losers?  When everybody didn’t get a medal?

Sort of has a “good old days” (or “kids these days“) ring to it, doesn’t it?

As a parent myself, I don’t neatly fall into any of the media-hyped parenting categories (who does?), but I do tend toward being a bit free range.  I believe that the world isn’t nearly as scary of a place as most people think it is, and that the best way for my children to learn to be citizens of the world is to live in it, without me hovering over them at all times.  I know my kids need to try (and fail) before they learn to do something themselves.  They won’t always be the best at everything, and I want them to know that (and also know that it’s okay).  I understand that winning and losing is part of life, and that learning to be gracious in victory and defeat – although difficult – builds character.  So you might think I would oppose the everybody-gets-a-medal-just-for-trying philosophy.  But I don’t.

I think it goes back to the first (and only) season I ran track in school.  I was in 8th grade.  I had always been okay at sports, but I had recently gone through puberty and – once my body starting changing – I became slower, weaker, clumsier, and much less confident in my physical skills.  I had never been interested in track and I’m not sure why I decided to join the team that year.  I wasn’t fast and couldn’t really jump or throw, but – to my and my coach’s surprise – I was a decent distance runner.  So my coach put me on the 800-meter relay team with 3 other girls.  At our first track meet, I was the third leg of the race and our team was in second place as I waited for the hand-off.  I took the baton and started running, overtook the girl in front of me, and finished my leg of the race with our team in first place.  It felt good, until I realized that the next member of my team wasn’t there to take the baton, the ref (a coach from the home team) was in my face yelling about something I didn’t understand, and my coach was grabbing me and pulling me off the track.  Apparently, I had my foot on the line of the handoff zone when I grabbed the baton, and I had disqualified my team.  Looking back, I realize that this was at least partially my coach’s fault – she had not thoroughly gone over handoffs with us, and I didn’t know about the handoff zone or the rules surrounding it.  I also know now that the ref who was screaming and yelling at me about how I was disqualified was totally over-the-top about the whole thing.  But I didn’t get any of that at the time.  I was a kid.  A kid who had failed not only herself, but her team.  I was mortified and embarrassed and sorry I had ever even gone out for the track team.  I finished that track season (my parents made me), but my heart wasn’t in it.  I never came close to running the 800 in the time I had run it in that first track meet, and I begged to come off the relay team for the rest of the season.

That was the beginning of the end of competitive sports for me.  I stopped playing softball and basketball, deciding to get an after-school job to earn some money instead.  The only high school sport I played was golf (a much more individual and somewhat less active sport), and I became a chubby teenager who didn’t get nearly enough physical activity.

I think the idea that participation medals are bogus and that it builds character for kids to lose rests on the assumption that all kids are competitive, and that losing a competition will drive kids to to better and work harder next time.  But there is another side to that coin, and 13-year-old Kendra is a perfect example.  For some kids, the competition itself will be enough to drive them away – they’ll never be brave enough to join the team or enter the contest.  And those who muster up the courage to participate once, like me, may never come back once they feel that first sting of defeat.  Those are usually the kids who need that physical activity the most – the kids who are clumsy or overweight, who have an intellectual or learning disability that makes it harder for them to understand the game, or who don’t have a parent who models physical activity or works with them on playing catch in the back yard.

Don’t get me wrong – I certainly think there is a time and place for competition.  That includes junior high and high school sports, and I’m sure I deserved to be disqualified from that race.  But I wonder if it would have been handled differently – if our team could have finished, if they would have quietly talked to me and explained what I did wrong and how I could do better next time, if there would been a little less emphasis on winning and losing – if I would have kept up with track and been a healthier teen.  I wasn’t a competitive kid and I’m still not competitive as an adult, so I wonder if I would have thrived in a program like Girls on the Run (that promotes self-esteem and healthy activity rather than competition) instead of a competitive track team.  I wonder if the parents and coaches who scream the loudest about how “kids need to learn that there are winners and losers” really care much about the kids at all, or if they are just somehow trying to relive their days of competitive sports.  Do they assume that, because they are driven by competition, that all kids must also have that same competitive drive?  Frankly, I suspect many of them aren’t all that interested in their own kid learning about losing, but are convinced their kid will end up in the winner’s circle so others can learn the lesson.

There is a time and place for competition, but 7-year-olds don’t need to play tackle football.  Nine-year-olds don’t need to throw 100 pitches a day 10 months out of the year.   3-year-olds don’t need to run soccer drills.  And a chunky 13-year-old who makes a mistake running her first track meet doesn’t need to be dragged off the track and disqualified in front of all her teammates in dramatic fashion.  Activity should be fun, and should be part of everyone’s daily life.

Kids are fatter and less active than ever.  Of course kids need to learn about winning and losing, but – when it comes to physical activity- the main lesson kids need to learn is that it feels good and is fun to move!  For some kids (usually the ones picked first for the team), competition is part of the fun, and those are the kids who should join competitive teams.  But in some ways, competitive sports reward the kids who are more active, who are “better” at physical skills, while the kids who aren’t so good (and frankly need more practice and activity) get cut from the team and sit the bench.  Competitive sports have their place, but they widen the gap between kids who are “athletic” and those who are not.  Perhaps we should realize that there is value in sports (and in people), even if they’re not competitive.  We need to reach out to the kids picked last for the team, and provide opportunities for healthy activity that doesn’t divide everyone into winners and losers.  Physical education class, school field days, and local parks & recreation sports should be places where ALL kids can feel comfortable participating in sports without worrying about being labeled a failure or a loser.

There are plenty of opportunities in life to learn about winning and losing.  But when it comes to physical activity, the consequences of failure – obesity, diabetes, heart disease, and premature death – are just too high.

I say keep the participant medals, and everyone wins.

[Creative-commons licensed photo by Flickr user Mike Saechang]

Get outside and get moving!

How much exercise do your kids get each day? The CDC recommends that all children participate in 60 minutes of physical activity each day, including aerobic exercise, muscle strengthening, and bone strengthening.  Sixty minutes per day may seem like a lot, but it is important to remember that children aren’t simply small adults. Kids (especially young ones) can’t stick with any activity for an hour, and they certainly aren’t going to be excited about doing 20 push-ups or 2 miles on the treadmill. The key to get kids moving is to break up activity into several shorter sessions during the day (for example, six 10-minute bouts of activity) and – most importantly – to make exercise fun. As summer approaches and we enjoy warmer temperatures, outdoor play provides the perfect opportunity to have 60 minutes (or more) of fun with movement each day.  Here are a few ideas for you and your kids to get outside and get moving:

  • Take a “penny hike.” Walk to a crossing, then flip a coin to decide which way to go. Repeat until you make it back home or are just ready to go back.
  • Go for a ride. Depending on your child’s age, a tricycle, bicycle, scooter, or roller skates are all great ways to get moving. Don’t forget the helmet!
  • On a hot day, turn on the sprinkler. Kids can run, jump, and hop through the water.
  • Have animal races. Pretend to be a bear (walking on hands and feet), dog (on hands and knees), elephant (one arm swinging like a trunk), kangaroo (jump), snake (slither), or crab (crab walk). Be creative and let your child choose his or her favorite animals.
  • Get out the sidewalk chalk. Draw a hopscotch grid for practice jumping and hopping. Create an obstacle course where kids can practice walking on a line or running, jumping, hopping, or crawling to different shapes and letters.
  • Climb, swing, and slide. Use the swing set in your back yard, or walk (don’t drive!) to your community park. Close supervision may be necessary, but let your child do the climbing, swinging, and sliding herself. It really is safer that way, and she’ll learn so much more.
  • Go back to the basics. Teach your child how to jump rope or hula hoop. Grab a ball and play catch, kick ball, or dodge ball. These inexpensive, classic toys provide almost endless opportunities for movement and play.
  • Just send them outside! If your kids are old enough and you are comfortable with the safety of the environment, turn them loose while you catch up on chores in the kitchen (stay within ear shot and check on them frequently, of course). If they’re younger or you live on a busy street, you may need to sit on the porch or patio and supervise. But the point is that kids need unstructured play, and lots of it, to learn and grow. Rolling in the grass, digging in the dirt, playing tag with siblings, or practice “tricks” like cartwheels and somersaults are important for children to learn about their bodies and the world around them. You can’t really teach a child that he’ll get dizzy when he spins around, or that he’ll fall down if he tries to walk down a hill too quickly. He needs to learn those lessons on his own terms.

Daily outdoor play is good for the whole family, and helps establish a life-long habit of regular recreational exercise for your child. Do your kids play outside every day? What are some of their favorite outdoor activities?

Barefoot is best

[Creative Commons Licensed Photo by Flickr user hlkljgk]

One of the most frequent questions parents ask me is, “What type of shoes do you recommend for my baby?” They are often surprised by my answer.

The truth is, the best shoes for emerging and new walkers are actually no shoes at all. That’s right – barefoot is best. When babies are crawling, pulling to stand, cruising around the coffee table, and even starting to take those first few steps; they need to be able to flex their forefeet and toes. They also need as much sensory input as they can get in order to feel the floor underneath their feet and know where there feet are in relation to their body. A hard-sole shoe just doesn’t allow for that (try putting on your stiffest shoes or boots and crawling around on the floor – you’ll see what I mean).

For toddlers and young children who are already walking, parents are often concerned about what appears to be “flat feet” and wonder if a special arch support or orthotic is needed. They are relieved when I tell them this is unnecessary. Flat feet are actually quite normal until age 6 or 7. Research shows that almost all typically-developing toddlers have flat feet (no visible arch in standing). At 3 years old, the majority of children continue to have flat feet. As children grow and develop strength in their feet and ankles, their arches develop. Although parents (and sometimes therapists) are tempted to place the child in a supportive shoe or order a custom or off-the-shelf arch support, there is no evidence this is helpful. In fact, it may even be harmful. Research shows that, in cultures where children under the age of 6 rarely wear shoes, there is a lower incidence of flat foot than in (Western) cultures where children typically wear shoes at young ages. So even for preschoolers, it seems that barefoot is best.

If a parent or caregiver has to put shoes on a young child who is an emerging or new walker (perhaps the childcare center requires it or the family is attending an occasion where going barefoot may not be appropriate), I tell them to simply think of shoes as foot covers. They really serve no other purpose, and they don’t need to. For crawlers and new walkers, I typically recommend a soft-soled shoe like this:

Image from robeez.com

This is a water-resistant leather or fabric shoe (foot cover) with elastic around the ankle. The sole of the shoe is also fabric, but slightly thicker and textured to prevent falls. This type of shoe allows for almost complete freedom of movement of the foot and toes, and allows quite a bit of sensation through the foot. Name brand styles of this shoe are widely available at Department stores, baby boutiques, and on the internet; but there are several off brands you can purchase for less than half the price at discount stores.

Once children are bona fide toddlers – walking exclusively and exploring by walking over many types of surfaces, including outdoors – I recommend something like one of these:

Image from robeez.com

Image from squeakers.com

The shoe at the top is similar to the infant shoe I recommend, but it does have a slightly thicker sole to protect the foot from things like puddles and sharp rocks. The shoe at the bottom is a more traditional shoe, but still has a soft sole. When I grasp this shoe, I can easily bend the sole in half. Again, these styles of shoes are available at multiple price points – and I have had success finding them at second-hand stores as well.

So the take-home message when it comes to infant and toddler shoes is this:

1. Barefoot is best. The best shoes for young children are no shoes at all, and hard-sole shoes should be avoided.
2. Flat feet is normal for toddlers and children up to age 6. Children need time – not expensive shoes or orthotics – to develop good arches.
3. Think of infant/toddler shoes simply as foot covers. Purchase the flimsiest, thinnest-soled shoe that will fit your needs.  There is no need to purchase an expensive “supportive” shoe, shoe insert, or orthotic for a child.

Of course, if you have concerns your child isn’t developing typically or if you notice her flat foot is so significant that her ankles are turning in, you should visit your doctor or physical therapist.  Otherwise, have fun [not] shoe shopping!

Kids these days, part 3

I recently attended a meeting for rehabilitation managers in my community titled, “New Graduates and Generation Y: Training for Emotional Intelligence and Face-To-Face Communications Skills.”  This is Part 3 in a series of posts on the themes of that discussion about the Millennial generation.  You may also want to read Part 1 and Part 2.

Yesterday, the New York Times ran a story about a kindergarten class that tweets 3 days a week.  After reading the story and viewing the accompanying video (see below), I couldn’t stop smiling.  With her class project, kindergarten teacher Jennifer Aaron is addressing the “technology gap” using a brilliant strategy, one I think we should model in our professional health care education classrooms as well as our clinics.   She has become familiar with the technology, has learned how to use it, and is teaching her students (and probably their parents) how to use it, too.

One of the themes that arose – and involved much discussion – during the area rehabilitation managers meeting I attended last week were concerns about students’ and new grads’ use of technology:

“Students and new grads are always texting, playing Words with Friends, and checking Facebook. They don’t have good professional boundaries when it comes to checking and using their mobile devices.  They know how to Facebook and text, but they struggle with “real-life” communication and relationships.”

These concerns are valid and often true.  We have some of these same frustrations with “kids these days” in professional education.  And why wouldn’t we?

Although there are many well-documented characteristics (stereotypes?) associated with the Millenial generation, what really sets them apart is their use of technology.  They are curious and fearless when it comes to technology.  They are constantly connected to their friends, family, and world in a way no other generation has before.  They enjoy mobility (smart phones) and real-time interaction (Twitter and texting).  They don’t want to be tethered to a PC (or even a laptop) or wait for email.  This technology has been around as long as they can remember, and they often identify as “digital natives.”  They are accustomed to using technology in every aspect of their lives – except education and practice.  The “head-in-the-sand, if-we-ignore-this-maybe-it-will-go-away” approach we’ve taken to technology (and – in particular – social media) in education and health care has not served our students well.  Suddenly, they enter professional education or a clinical internship (or even a first job) and they’re told they’re supposed to put their mobile device away.  But they don’t wear a watch, so how will they tell time?  And what about the anatomy app on their phone they use for quick reference?  They should hide their social media profiles (or at least make them private).  But what if they want to “like” the America Physical Therapy Association on Facebook?  Tweet a link for a new Physical Therapy Journal article they just read? Or start a blog and a Facebook page where they can (gasp!) friend their patients so they can share good, reputable health care information?

The truth is, many Millennials don’t know how to use technology and social media in a professional, appropriate way because no one is teaching them.  No one is modeling it for them.  They are figuring it out on their own, and when they make mistakes, us old folks wag our giant fingers at them and say, “I told you that texting/tweeting/Facebooking/smartphone app using wasn’t a good idea.  We should just ban it all.”  How’s that working for us?

We all need to take a cue from Ms. Aaron and her kindergarten class.  Part of the professional PT education curriculum should be about appropriate, professional use of technology and social media.  Instead of telling our students to “turn off and put away” their mobile devices, we should be using them during class as an opportunity to engage students in education and the profession, all the while teaching them to be better digital citizens.  Schools and health care facilities should re-think broad policies banning mobile devices and social media.  It is time that we recognize that social media is part of “real life,” and that the next generation of health care providers will be expected to have technology and social media skills.  Their patients (and the public) will demand that they engage with them using social media.  They will walk into a clinic with no Facebook page, no Twitter feed, and no blog; see a physical therapist walk up to them with a paper chart and a medical reference book and wonder, “Is she practicing physical therapy like it’s 1995, too?”

It is time to stop approaching technology and social media in health care and education from a risk management perspective and start approaching it as an opportunity to educate, learn, engage.  An opportunity to elevate our practice and the profession.

If Ms. Aaron and her kindergartners can do it, we can, too.

Kids these days, part 2

I recently attended a meeting for rehabilitation managers in my community titled, “New Graduates and Generation Y: Training for Emotional Intelligence and Face-To-Face Communications Skills.”  This is Part 2 in a series of posts on the themes of that discussion about the Millennial generation.  Part 1 can be accessed here.

“Students and new grads [Millennials] don’t seem to have the listening skills they once had.  And they don’t have the self-awareness to reflect and correct, and they often get defensive or emotional when criticized.”  This was one of the central themes of the rehabilitation manager meeting I attended last week.  Kids these days don’t listen, they won’t learn, and they get upset when someone with  little more experience tries to tell them how to do it better.  In other words, Millenials are immature and they don’t respect authority.

This is a common criticism of Millennials and one that – as an educator – I certainly understand.  But I think that, when we examine the characteristics of Millennials, it it clear that the problem isn’t that Millennials don’t respect authority.  It’s just that Millennials view authority differently than the generations before them.

It is true that Millennials are confident, and sometimes that confidence can seem arrogant.  It can appear that they aren’t listening or reflecting when they continue to do things “their way.”  Millennials are social and informal.  They get along well with their parents.  Similarly, they want to like their instructors and bosses and have casual, friendly relationships with them.  The boundaries between “work” and “play” are blurry, and Millennials may have difficulty hearing professional criticism from a colleague and not taking it as a personal attack from a friend.  Millennials like teamwork and value open communication.  They believe that others on the team want to hear their thoughts and ideas, and they share them freely.  When they are frustrated about a work situation or don’t agree with criticism, they aren’t afraid to express their feelings.  To a Baby Boomer or Gen Xer, this way of relating to coworkers can seem immature, unprofessional, and just plain uncomfortable.

Here are a few of my suggestions for improving the “authority gap” between Millenials and Baby Boomers or Gen Xers:

  1. Build time into the day for communication.  Allow time after a treatment session for a patient or family to provide feedback about home exercise program instruction.  Schedule time at the end of the day to communicate with a colleague or clinical instructor about an intervention technique.  These will give the student or new grad opportunities to practice receiving (and giving) constructive professional criticism.
  2. Millennials love technology  – use it!  Get permission first, then grab a video camera or smart phone and record a student or new grad conducting a patient interview or education session.  Allow him to view the video and reflect on his performance and communication skills.  Discuss what he did well, and what he should do differently next time.  Again, this gives practices with communication and provides an objective way to self-reflect.
  3. Position yourself not strictly as an authority figure, but also as a mentor and advocate.  Millennials value relationships and are fiercely loyal.  This can be a tricky one – you want to be a guide, not a friend – but once you’ve established a relationship of mutual respect, you may find the student or new grad listening a little more and accepting criticism without defensiveness or emotion.
Have you experienced the “authority gap” in your classroom or practice?  What strategies have you used  to close the gap?
[Creative Commons-licensed image by Flickr user xflickrx]

Kids these days, part 1

Last week, I was invited to a meeting for rehabilitation managers in my community. The title of the meeting was, “New Graduates and Generation Y: Training for Emotional Intelligence and Face-To-Face Communications Skills.”  Uh-oh.  I was invited because of my role as an academic faculty member in clinical education, but – with a 1978 birthday – I’m considered a member of Generation Y (also known as Millennials) according to some sources.  I’d never been to one of these meetings before, but I knew some of the key players were of the Gen X and Baby Boomer generations.  I’d be lying if I said I wasn’t a little worried I’d be spending the better half of the morning defending my students and myself.  But I knew I had an important perspective to share; that I was in the unique position to speak on this issue as an educator and a (maybe, almost) Millennial.

If you’ve spent much time with me, you know that I’m completely turned off by the entire kids these days concept.  I don’t think there’s anything wrong with kids these days or society today.  In fact, I think people and the world generally get better as time goes on.  We are safer and smarter than we’ve ever been.  And, while kids these days may be different (and why wouldn’t they be – the world is different), they have unique ideas and strengths and skills that I don’t possess.  I can learn a lot from people younger than me. And that’s a good thing. Perhaps that is why I was drawn to pediatric physical therapy and education.

Luckily, the meeting wasn’t simply a forum to vent about problems with kids these days.   It was an honest, fascinating, and enlightening discussion, with many of the Gen Xers and Boomers in attendance reflecting on their own biases and weaknesses as well as some of the “differences” they see in today’s students and new grads.  Here are a couple of the central themes that arose during the discussion:

  • Students and new grads don’t seem to have the listening skills they once had.  And they don’t have the self-awareness to reflect and correct, and they often get defensive or emotional when criticized.
  • Students and new grads aren’t as dedicated to the profession. They want to leave as soon as the day is over.  We used to stay 10 or 11 hours if needed to get all our work done.
  • Students and new grads are always texting, playing Words with Friends, and checking Facebook.  They don’t have good professional boundaries when it comes to checking and using their mobile devices.
  • Students and new grads know how to Facebook and text, but they struggle with “real-life” communication and relationships.

This generational divide isn’t unique to physical therapy or health care – the same conversations are happening in many professions.  And it isn’t unique to the Millenials – concerns about kids these days is a tale as old as time.  What’s different this time, I think, is that some of the unique characteristics seen in the Millenials may be less about a specific generation of young people and more about a vast change in the world we live in, the way we do business, and the way we communicate.  In many ways, Millennials represent the role that technology – particularly social networking and mobile devices – now plays in our lives.  We may not be able to just wait them out or ask them to grow up or adapt or change to conform to us.  The Millennials may represent what we need to become in order to stay relevant.  And that can be a frightening prospect for many of us.

Over the next several posts, I’ll tackle these generational issues in a series I’m calling (you guessed it) Kids These Days.  My next post will be about the first item on the list: students’ and new graduates’ ability to listen, communicate, and self-reflect in today’s fast-paced world of health care.  In the meantime, I’d love to hear your thoughts on the next generation of health care providers.  What do you think about kids these days?  What differences are you seeing in your classrooms, hospitals, and clinics?  What strategies are you using to close the generation gap?

[Creative commons licensed photo by Flickr user courosa]

Is the Bumbo a no-no?

The Bumbo baby seat is one controversial piece of polyurethane.  Do a quick google search for “Bumbo seat” and you’ll see what I mean.  Mommy blogs and parenting forums are full of passionate posts of love and hate for the Bumbo.  Many physical therapists and parents of children with special needs have strong opinions about the seat, too, largely because the seat is marketed using language usually used to describe therapeutic equipment.  The manufacturer of the product makes the following claim on their website:

“The seat stabilizes the child into slight hip flexion, placing the pelvis in a slight anterior pelvic tilt which facilitates lumbar extension. This action, combined with the gentle curve of the seat back that matches the natural curve of the rib cage, facilitates the baby around the lower ribs and trunk for stabilization. The Seat allows for active practice of the head and postural trunk control. It also allows a child the pelvic stability needed to get the hands into the midline for play. Upright positioning facilitates an improved visual field of the environment, improved respirations and breath control, assists a baby who needs to be upright after feeding due to reflux and many other benefits.”

Although the statement is in quotation marks on their site, the manufacturers don’t give credit to the individual who provided the quote, nor do they cite any studies.  To my knowledge, there is no research to support or refute the claims made by Bumbo International.

I own one of these seats.  I have used these seats with my own children as well as the children I’ve worked with.  I have recommended parents purchase these seats.  I’m not sure whether the seats accomplish what they claim to accomplish, but I’m not sure I care because – and here’s where I’m going to say something you never thought you’d hear a pediatric PT say – development is about so much more than the position of the pelvis (cue angry comments from every other pediatric PT who reads this post).

The shape and material of the seat sort of “grabs” the baby without the need for any straps or belts.  Unlike infant car seat carriers or bouncy seats – which put the baby in a “C” shape with the legs relatively straight – the Bumbo has a dip in the back of the seat, bending the legs with the knees slightly higher than the hips.  Although the seat curves around the trunk, providing some support for the mid-back, the upper back, head, and neck are unsupported.  This means that a baby who isn’t ready for the seat looks like my oldest son, M,  looked in our Bumbo when he was 2 months old:

Notice that he is slouching with his head and trunk leaned to the side.  You can’t see his pelvis, but I imagine it is tipped backward (although I don’t blame that on the Bumbo – at this age his pelvis would be tipped backward in any form of supported sitting).  At 2 months old, he hasn’t developed the ability to consistently bring his hands to midline and reach for toys in supported sitting, so there’s really nothing he can DO in the seat at this developmental stage.  Bottom line is, If a baby looks like this in the Bumbo, it is a good indication he isn’t probably ready.

But look at what happened when we put him in the seat at 4 months old:

This isn’t the greatest picture of his posture in the seat.  He looks pretty upright, and you can tell that he is even leaning his trunk forward away from the back of the seat rather than collapsing into it.  This makes me think his pelvis is probably tipped forward, but I can’t tell here and I can’t really remember.  What I do remember about this day and this picture, however, is how excited he was to be sitting up and playing with the toy in front of him.  Bumbo seats were pretty new at that time, and the tray wasn’t on the market yet, so I covered a cardboard box with contact paper, cut out one side, and turned it upside down in front of him as sort of a table.  Using a Bumbo seat with a tray gave my son – who wasn’t yet sitting on his own but was very much ready to get upright and see the world – the opportunity to practice his reaching skills and work on his upper trunk muscles in preparation for sitting.  And he was delighted doing it, and I was delighted to be interacting with my infant like he was a real boy.

My children are typically-developing, but the Bumbo has also worked well for many infants and toddlers I’ve seen with developmental disability and delay.  Infants typically begin sitting independently between 5-8 months.  The Bumbo seat can allow a similar-aged child with delays to sit supported on the floor, interacting with his peers, siblings, and/or caregivers at eye-level.  This is so critical for social development, and I’m not aware of any other piece of commercially available equipment at this price point that allows for this.  For kids with cerebral palsy or similar diagnoses who tend to arch with stiff muscles, the Bumbo seat can keep their hips bent and help  “break up” extensor tone and allow them to sit up and play.  For other kids with diagnoses such as Down syndrome that tend to have low muscle tone and difficulty holding themselves up against gravity, the seat gives them the support to sit upright (as long as they do have some head, neck and upper trunk control) for the first time and interact with their environment, peers, and family in a meaningful way.

In my opinion, the Bumbo seat can be very effective when used with the right child at the right time, allowing for good practice of upper trunk and head control – as well as arm use and social interactions – in upright sitting.  It is true that, for some kids, the deep well of the Bumbo seat does lead to a flexed back and rounded pelvis in sitting.  However, for the age children the seat is designed for (pre-sitters and children with emerging sitting skills), a posteriorly tilted pelvis and rounded spine are a typical sitting position.  Once baby is able to sit independently with an upright pelvis and spine, she wouldn’t need the seat anyway.  Like any piece of equipment, the Bumbo seat should be used in moderation.  Floor play (tummy time!) is always best for development and learning.  And certainly a baby who is an emerging sitter should be practicing that skill outside this seat as well.  Part of learning to sit is learning to move in and out of sitting, shift weight, fall and correct, and none of those things can occur in the Bumbo.

I do disagree with the recommendedation that Bumbo be used for babies age 3-10 months.  I think 3 months is a little early for most babies.  And, once a baby is able to sit alone (typically between 5-8 months), there really isn’t any benefit to this seat .  By about 6 months, most babies are starting to learn to move by creeping, crawling, or rolling and aren’t going to want to be “stuck” in this chair, nor should they be.  I’d say this chair is most appropriate for a typically-developing 4-6 month old, and – realistically – most kids aren’t going to use this seat for more than 1-2 months, tops.  For families with infants who are delayed or have special needs, the seat may be used for a longer period of time.  And it is nice in that it is a readily-available and reasonably-priced seat that may also be used by the baby’s non-disabled peers, so it doesn’t look like a piece of “special” equipment.

Of course you should always talk to your health provider or therapist about your child’s unique situation, and – to avoid injury – the Bumbo should NEVER be used on a raised surface.  The Bumbo is certainly not a “must have” for most babies.  But if you think the Bumbo will work for your family and you’re willing to shell out $40 for a seat that may only be used for 1-2 months, I say the Bumbo is a go-go.