Wednesday, December 28, 2011

Somehow we Reflections on 2011

Well, here we are. It’s the last week of December.  Leftovers stock the fridge. Recycling bins overflow with a gazillion plastic and cardboard pieces. New toys clutter the floor. And hopefully, you are enjoying some lazy mornings in your PJ’s with your children like I am this morning.

While 2011 comes to a close, I think it’s natural to look back to the past year and look ahead to the New Year. It always gives me a desire to look back and the memories our family has made. I’m working on a 2011 photo book (no time for scrapbooking this year!) and my girls and I will work on a photo collage for our Christmas book of all the beautiful faces we received on Christmas cards.

 I find myself also looking back at the past year in terms of progress for our growing little family business, Milestones & Miracles.  In a few weeks (if the shipping gods smile favorable on us), we will receive 1000 units of our first product, 1-2-3 Just Play With Me.  In a nutshell, it is a decorative boutique style box that houses 75 large cards. The cards pair milestones expected at each age with interactive, creative play ideas in each of the 5 areas of infant/toddler development, along with some reference material pertinent to parents.  (More info at our website: When I sit still for a minute and realize that this “dream project” as we originally called it, is on it’s way to us, it sort of blows my mind.

My best friend and I authored it and somehow we moved from a simple conversation beachside in Nags Head, NC that started with our shared realization that new parents are often too tired to read “the baby books” but want to learn about their baby. In addition, we realized that there are numerous products on development OR play ideas but nothing we knew about that paired them together.  And in our minds, nothing can be more enjoyable than parents knowing why their children are doing certain things and feeling empowered to relate to them through play. It’s said that play is the work of childhood, so why not make something that is easy to use, simple, and helps parents learn about how their babies “work,” while giving them fresh ideas and confidence to jump in and enjoy and bond? 

Sure, why not! When I look back now, we ourselves had infants sleeping in Boppy Pillows in a beach tent and were juggling our daughters and work and home life.  What were we thinking?! Somehow we moved from idea to research and writing, to proofreading and more proofreading, to finding and working with a terrific graphic designer, to learning about copywriting, and printing, and mass production.  We “non-techy” therapists learned from supportive friends about websites and blogs.  We talked to other small business owners about the practical sides of web sales. We reached out to leaders in early intervention for advice and opinions. And somehow, here we are. Waiting (impatiently) for 1000 copies of our vision to arrive.

It makes me laugh to think we did this with kids in tow (asking dreamily if this would be in Target (the biggest of dreams for them!) and supportive husbands by our sides. Life moved on with a household move, the news of a new baby to come (not me!) and two of our children starting kindergarten. In reflection, it seems overwhelming to me, but in reality it was not. I believe that when you are passionate about something and have a vision, things eventually fall into place. That’s what happened with us. We believe wholeheartedly that parents are the best teachers of children and that regular and real interaction (the kind that often makes messes or noise and is sprinkled with hugs) let’s babies and toddlers know they can trust and rely on the big people in their lives. That’s why we did this.  We wanted to encourage parents to jump in and enjoy each milestone because they do pass so quickly. When our focus stayed on this vision, and with the many generous people in our lives who offered advice, help, proofreading, and prayers – we somehow got….here.

So, at the end of 2012 Lacy and I thank you all. Thank you for reading. Thank you for your support. Thank you for encouragement. And thanks to those who believed in our “dream project.”  As soon as our shipment hits our door (I really still can’t imagine what 1,000 of these boxes will look like!), we will let you know! Sometimes, the hardest part of a process like this is stopping all the work and planning, inhaling, and waiting to see how it turns out!  I don’t know if we made all the right choices, but we’ll never know, until we try, right? So we wish the same excitement and anticipation of something good for you in 2012…. that you will take the risk with whatever your “dream project” is right now.  New job? Dream Trip? Baby? Reuniting with old friends? Learning to play and instrument or sew? Running your first race? Or maybe simply slowing down and being fully present with your family? DREAM BIG! TAKE THE RISK! ENJOY!!
Monday, November 28, 2011

Borrowed Words. Sometimes they are JUST what you need

Sometimes, someone else's words are a better fit than your own. Today is one of those days. I woke up and read a blog of a friend of mine. She is the mother of a former patient named Brenden (and for the record I have her blessing to share all this information). Anyway, Brenden is a bright, funny, sweet boy who happens to have Spinabifida. On the day he was born, he visited three different hospitals and his worried mom followed behind him. Around that time, I was very busy with my work as a physical therapist and wasn't taking new patients but I got a call from a mutual friend of mine and Brenden's mom Michelle who shared his story and told me I WOULD be taking him on as a patient. 

You know how sometimes you think you just don't have time for one more appointment, not another "to-do" on your list, not another responsibility, and it turns out to be just what you yourself needed? That was Brenden for me. That little boy and his family, like many of my patients are, were a gift, a lesson, a blessing in my life. So today, I share with you, his amazing mother's words. 

Beyond the job of being a mom, she has found ways to help many other families who live with Spinabifida or other special needs. She even recently ran the NYC marathon to raise awareness and to honor Brenden's hard work.  Lacy & I know we are fortunate to meet incredible people along the way in our jobs and I'm honored to share Michelle and Brenden with you. She is "paying it forward" big time and inspires me to find ways to do the same. I hope she does the same for you.

Meet Brenden. He loves cookies!


From her blog found at:

Sunday, November 27, 2011

I recently received an email from a friend from college....someone I hadn't talked to, well, since college. No reason really for us not talking, we just each went our own way. She's an Occupational Therapist and recently met a family who just found out their baby will be born in March with Spina Bifida. This young couple is so broken over the diagnosis, has no family close for support, and really don't know what to do. My friend asked a simple thing of me: Would I mind writing them a letter, telling them of our journey, where we've been, how far we've come, and any other words of wisdom I wanted to share with them. As I sat down to write this letter, I was at a loss for what to say. There was so much I wanted to say, so much they needed to hear, but I didn't really know how to start. I didn't want to say, "I'm sorry." Because I know how much I hate people saying that to me. I hate when people look at Brenden walking with a walker, and say, "Oh honey, I'm so sorry he has to use that." I'm not sorry, I'm glad that such a thing exists to allow him to walk. I'm glad that he has gained the strength in his legs to be able to use a walker. Moving I emailed my friend telling her I wasn't sure what to write. Her response, was simple, "What does having a child with special needs mean to you?" And those 11 words were all I needed.

The hours following Brenden's birth were gut wrenchingly painful. I experienced every emotion possible. I cried. I cried some more. I told my dad there was no way I could do "this." Not realizing then what "this" was. I was thrown into an unfamiliar world of neurosurgeons, urologists, OT's, PT's, Speech Therapists, and specialists I had never heard of. No one asked if I wanted to be in this place. And back then, I didn't want to be. But God had chosen me, and as much as I hated every minute of it, the UVA NICU was where I needed to be. It was where I held my baby boy for the first time. It was where I heard his sweet cry for the first time. It was where I realized just how lucky I was because I knew he would make it, when some of the babies around him would not. It was in that NICU that I went from being a scared young woman to being a strong mom. It was in those moments of not knowing what the future would hold, that I realized I had no choice but to dry my eyes, pick myself up, and do what I needed to do. I had a choice: sit around and wallow in the sadness that my child may never walk, talk, or have a "normal" life, or make sure I gave every ounce of my being to make sure he had a better than "normal" life.

Having a child with special needs is no easy task. But it's the most rewarding thing I have ever experienced. It has taught my patience (though I could use some more). It has taught me that nothing in life should be taken for granted. It has made me realize how much the little things really do matter, from small milestones to the big ones, each moment is to be treasured. It has allowed me to see things for what they are really worth. Having a child with special needs is not a burden, despite what so many people think. I have learned that the world is ignorant when it comes to differently abled children, but it's my job to educate others, so that someday, it won't matter that a child needs to use a walker or wheelchair.

I have found strength I never knew I had. Whether it's having the strength to speak up with I disagree with a doctor or the school system, or finding the strength to put my child into the arms of a surgeon, Brenden has made me strong. He makes me want to make a difference in this world, not only for those living with SB, but for every person who is differently abled. I want doctors to realize that a child is not defined by a diagnosis.

Spina Bifida is not an excuse in our household. We don't allow it to be. I don't pity Brenden, and it drives me nuts when other people do. He can and will go far in life. Nicole, Brenden's PT with Birth to Three, told me several times to never lower my expectations of him. And I don't. He's expected to do the same things as Madelynn: put his dirty clothes in the hamper, pick up his toys, put his coat away when he takes it off, etc, etc, etc.

To sum it up, being the parent of a child with special needs is a pretty special thing. It's not always peaches and cream, there are days that I wish I could make it disappear. But for every day like that, there are twice as many days that make me thankful to be in this place, thankful that God saw fit to trust me with Brenden.
Monday, November 21, 2011

Teaching your kids to give

Remember that old saying, "Tis better to give than to receive"?  Well about this time every year, amongst all the gift wish lists and crazy shopping, I try to remind my children (and myself) of this life lesson.  It's not easy, nor am I always successful with my moral lesson, but I try!  Below we listed some websites and organizations that we have donated to in the past.  All of them are related to giving to other children.  I think if we expect our kids to understand the importance of giving to their neighbor, we need to choose a charity or organization that serves children.  Then it will be easier for your child to empathize with the child in need.  So as you are finalizing your holiday budget, considering cutting a few corners so that you can include a donation to someone in need.  Not only will you be teaching your child about charity, you will feel good about yourself too!

Project Night Night - A wonderful non profit organization that provides tote bags for you to stuff with a stuffed animal, blanket and book.  The tote bags are then distributed to homeless and domestic violence shelters to children in need.  Most of our children enjoy a story before bedtime and snuggle a "lovie" as they drift off into dreamland.  How sad it is to think that some children are so quickly removed from their home and moved into shelters that they may not have time to grab any of their belongings.  These night night packages hope to bring sweet dreams to all children in need.

World Vision - Their slogan is "Building a better world for children" it!  World Vision offers many ways to support children in need and fight hunger around the world.  You can sponsor a child, purchase animals, donate to help provide clean water, and many other donation opportunities.

Samartian's Purse - Every year around the holidays Samaritan's Purse sponsors "Operation Christmas Child".  By filling a shoebox with small toys and hygiene essentials, you could be giving  a child around the world the only Christmas gift they will receive.  To help your child better understand the impact of their gift, you can track your shoebox online to find out what country your shoebox is distributed and write a letter to the receiving child in the hopes of hearing back from them.

Read to Me - A non profit that distributes care packages to underprivileged new moms in hospitals.  Included in the care package is a new book, onesie, tote bag and a special note to mom explaining the importance of sharing the joy of books and reading with their newborn baby.  You can make a monetary donation at

Nuru International: Founded by a WV native and a team of professionals who left high profile employment, Nuru is an innovative non-profit that sees the larger picture: extreme poverty feeds extreme terrorism. Nuru uses a grassroots approach to teach agriculture, leadership skills, education techniques, water and sanitation techniques, and health care techniques to area leaders to foster self-sustaining communities and ultimately ending poverty one community at a time.

Berkeley County Back Pack Program (or something similar in your community): The Back Pack Program was implemented in order to meet the needs of children when food resources are not available. Their main food source is what they receive at school. This program provides children with healthy and easy to consume foods that can be take home on weekends.Recommended items: Juice boxes,small water bottles, fruit cups, applesauce cups, individual size cereal boxes, granola bars, cheese/peanut crackers, pop tarts, raisins & small microwavable meals. Food that can be easily opened and prepared by a small child. Donations can be coordinated through their Facebook site: BC Back Pack Program

Jessica Rocks for Timmy's Fund: A non-profit that encourages creative fund raising for adults and kids to participate in -- with all funds going to support families whose children are undergoing treatment for cancer. 

There are so many ways to give. A shut in neighbor. A women's shelter. A soup kitchen.  Finding a place to teach our children to care for those around us is not the problem. Finding the time to do it and making it intentional is harder, but the lessons learned through hands on giving are greater than most things we try to teach and are certainly something to be thankful for.
Sunday, November 6, 2011

Christmas Shopping with a PLAYFUL PURPOSE

As much as I am a "Thanksgiving advocate," it is happening. All around us, Thanksgiving is being skipped over (not to mention poor Veteran's Day!).  The stores all seemed decked out with holly by Halloween and I've even heard a few carols. I know Christmas is quickly approaching when I open my mailbox and 4-5 toy catalogs fall out daily. I've paid specific interest to the contents of those catalogs this year.  In preparation for 1-2-3 Just Play With Me arriving in January and doing a good bit of research to prepare for an early childhood conference we are speaking at in early 2012, we have read extensively about toys as tools for play and had some great conversations about what is available on the market today.  Here's our verdict: It is not an easy task to find a "good toy" in large chain stores. There are some but they are the minority. What defines a "good toy" in our minds? One that can be used for several years in multiple ways. One that is durable, safe, and not overpriced. One that doesn't "do it all" for your child.  In a recent article in Parents magazine, the founding director for the Alliance for Childhood, Joan Almon states, "A good toy is 95% child and 5% toy." We couldn't agree more.    

So for all you parents who have early holiday shopping giddiness, we challenge you to ask yourself the following questions when standing in that toy aisle:

- How many ways can I think of this toy being used?
- Will this toy promote language and social interaction for my child when playing with it?
-Can I creatively think of ways this toy can be used rather than it's intended purpose?
- Is this toy age appropriate for my child now and will he/she still find it interesting in some way in 6 months to a year?
- Is the toy safe?

 Working in the homes of families with small children has many benefits, but one is that I see first hand which toys are played with time and time again and which are pushed to the corner. I often embarrass my husband and kids in the stores around this time of year because when we find ourselves standing next to parents or grandparents in the toy section, I can't help either talking them into a toy or out of another!

The bad news is that you might have to search a bit harder for a great toy on your list for that special child in your life, but the good news is that often the toys that don't "do it all" for your child, are more reasonable.  And being creative in your toy shopping can be quite fun.

Here's some suggestions:
- Most children would love a trunk filled with dress up clothing (for boys and girls) from your closet or a thrift shop
- Consider taking the dollars you'd spend on a big toy and instead purchasing an art center for a child.  You can pick bins or shelves with baskets of art supplies (some purchased like paints and paper and some saved likes bottle caps or paper towel rolls),  or maybe an easel or dry erase or chalkboard for endless hours of creative artistic play
- Search for toys that can be used many ways.  When I was a child, my parent's old calculator had to serve as a phone, calculator, computer, cash register, and space ship. We don't need to provide a separate toy for separate functions.  Allowing children to translate their knowledge of an object or toy to a different purpose, builds problem solving and creative thinking skills.
- Don't forget about music. I haven't met a kid who doesn't love a harmonica as a gift. They are very reasonable and unique.
- Give the time of you sharing an experience with a child. Tickets to a play or show, a museum, or aquarium alongside a special adult are a lasting treasure.
- Don't forget physical toys. Winter keeps some of us indoors, but remember that kids need to move to learn and to behave! Jump ropes make excellent stocking suffers and can be used in a variety of ways. Every child should have a ball to play with.  Hula hoops are fun for toddlers and adults!
- Magic sets, puppet shows, or kid friendly cook books with some cooking supplies are not commonly advertised, but nice choices for cooperative play. 
- Dolls and blocks are probably our favorite "bang for your buck" toys because they can be used in so many ways for so many years. Both promote language, social, and motor play and require all kids and no batteries to operate!
- Look beyond the "regular stores." You can often find deals online or unique items in smaller shops.

We wish you a happy shopping season and hope these tips are helpful.  You WILL always be your child's favorite toy, so no matter what you choose, don't forget to add your time and your attention on your list of gifts to give that special child in your life!

This shot of the my daughters' first Christmas together makes me smile! I knew our oldest might put lots of things from the house inside her new shopping cart....I never thought the first would be her baby sister!           
Monday, October 24, 2011

Raising Healthy(er) Eaters!

I’ll be the first to admit I don’t eat the healthiest.  I enjoy my junk food, sweets and occasional sodas.  But I want to teach my kids differently.  I want them to make healthier food choices earlier in life.  I also want them to eat what I cook!

I have had numerous discussions with members of my “Mommy Posse” about kids and food.  Why won’t they try something new?  How can I get them to eat their meals?  Should I say no to a snack if I know they are truly hungry?

In raising my 5 and 3 year old thus far, I have learned a few tips I want to share.  Most of the ideas are borrowed from other mommies (and daddies) who, like myself, don’t want to be a short order cook!

1.  Limit snacks throughout the day.  Certainly when your children are babies, you should feed them when they are hungry.  But kids quickly learn that if snacks are freely given, they don’t have to eat their meals, because something better will be given to them later.  In my house, if my kids don’t eat the food on their plates at dinner and they ask for a snack later, it has to be a “healthy” one.

2.  Teach them early about healthy food choices.  Print off the Food Guide Pyramid or “MyPlate”  ( , talk about portions and let them help you pick out the menu.  Another good idea is to let them help you cook.  Often times, if kids are involved they are more like to try something new!

3.  Limit drinks.  Certainly if your child is thirsty, let them have water.  But be careful, little bellies can fill up on milk, juice, etc. and not be hungry when mealtime rolls around.  Sippy cups were a wonderful invention.  However, we allow kids to drink from them for too long, out of convenience for us (less spills to clean up), and our kids have access to them all the time.  Try keeping the cup at the table or in the fridge so your child only drinks when they are truly thirsty.

4.  Only eat in the kitchen.  If kids have to stop playing to eat, they will be less likely to graze all day long.  I just recently employed this rule in our home after a recent move.  (I’m trying to save my new carpet!)  Needless to say, my kids aren’t too happy.  However, I’m finding that they are eating meals a little better and snacking less throughout the day. 

5.  Define what are healthy foods and not so healthy foods.  In my house there are only two food groups:  healthy and junk.  Healthy foods include veggies, fruits, grains and meats.  Junk includes candy, chips, soda, etc.  My 5 year old clearly knows the difference and doesn’t ask for anything from the “junk” category when it is off limits.

6.  Avoid being a short order cook.  I know there are some really picky eaters out there and you have to feed them something, so this tip may not work for you.  However if you can meal plan so that each child likes at least one of the sides you are serving with a meal, then you should be good to go.  Don’t fix a different meal for each kid, you’ll run yourself ragged and mealtime will become misery time.

7.  Try the lights out approach.  Another rule in my house related to the kitchen is that when the kitchen lights are off, that means the kitchen is closed.  SO DON’T ASK MOMMY FOR A SNACK!  Some days I was felt like I never got out of the kitchen between fixing meals, cleaning up and serving snacks!  This rule has again helped my kids to limit the food begging.

8.  To piggyback on the Food Guide Pyramid and MyPlate, have your child help you create a meal checklist to help ensure that each healthy food group is represented at every meal.  Or you can keep a picture of MyPlate or the Food Guide Pyramid posted on the side of the frig and after your child fills their plate have them check to make sure they have appropriate portions and all food groups represented.

I hope these tips are useful to you and your little ones in helping you solve some of the food battles in your home.  If you don’t have any, consider yourself blessed!

Below is a picture of my youngest helping me make pumpkin pie (I told you I like sweets!).  Much to my surprise, because I involved him in the creation of the pie, he was super excited to taste it.  And because he is MY son, he loved it J

Saturday, October 15, 2011

Yoga for Kids and for FUN!

In the past few years, I've grown to love and cherish a weekly yoga class. I was longtime "aerobics girl" who spent years teaching and taking every "hot" class at the time, from step aerobics, to body pump, to Pilates. I even had some aerobics records back in the day and a worn out Cindy Crawford VHS. Well, I never quite turned into a super model, but I do love exercise and the switch to yoga was not exactly an easy one. I not only had to train by body, but for the first time, had to train my mind. For a mind that seems to goo 100 mph in 5 different directions at any given moment, this was no easy task. It took time and it took help, but with practice, I learned to turn off the continuous to-do list that scrolls through my brain as constant as the ticker at the bottom of the ESPN screen that runs pretty continuously in our house! I learned to center my thoughts and actually - be still, and be (gasp) quiet! Ironically, that silence has helped be hear some pretty important things. 

When I became interested in yoga for myself, I wanted to share my new love with my other loves - my daughters and my patients. So, I took a continuing education course titled, "Integrating Yoga Into Your Pediatric Practice." It was right up my alley. The pamphlet said to come barefoot, in yoga pants, and with a mat -- my kind of CE course! We spent all day doing yoga that would appeal to children and learning how to incorporate this with a purpose. It was so fun!

Did you know that besides increasing flexibility and strength, yoga can improve body awareness, posture, motor coordination, concentration, digestion, circulation, mood, self esteem, and sensory regulation? Who would not want that for themselves or their kids? Plus, as winter approaches and more time is spent indoors this is something you can do with your children that can benefit all of you.

One of my daughters' favorites is to do poses that are animals. Here's a few to share.  Add the corresponding sounds for fun!

Down Dog
Up Dog
Down Gorilla
Up Gorilla





Sleepy Bear

Crouching tiger
Lunging tiger

In addition, yoga focuses on breath. I was shocked as a newcomer to yoga how much simple breathing can calm you down. At times my kids roll their eyes, but when they get upset, they'll hear me say "Smell the flowers, blow out the candles." Inhaling and bringing their fingers to their nose, and the exhaling and leaning forward repetitively helps them focus and calm down.

Smell the Flowers
Blow out your candles!

You can also have them lay down and breath deeply using a feather or a balloon to give them a visual target to move with their breath.

The teacher of the course suggested "story book yoga." This means that you take a favorite story book and use the pictures in it to inspire yoga poses. I did this once with my daughter's preschool class and they loved it! Great books to try it out with are any of the Eric Carle favorites. 

Meditation was always the hardest part of my yoga class at first. Being still doesn't come naturally to me. On a few  occasions when my children have been really stressed, I've gone as far as trying the techniques I've learned in class on them.  I have to say, they were either successful (or my kids thought I was losing my mind), but they enjoyed a candle and some rain sounds on the I-pod while lying down and breathing!

You can find lots of information on yoga for kids on the internet. We enjoy: (they have super cool mats for kids too)

So the next rainy (or snowy) day that comes your way, consider getting active through yoga with your kids! You might feel silly at first, but I promise that the feeling of silliness is quickly replaced by belly laughs and fun. Namaste!
Monday, October 10, 2011

Hearing is Essential!

Hearing is vital to the development of speech of language in your child.  So please carefully consider today how WELL your child hears.  All newborns are screened before they leave the hospital which helps detect hearing loss earlier in babies.  But then frequent ear infections, medications that are toxic to the ear, illness (like meningitis, measles, flu), head injury and noise exposure can all lead to hearing loss later in childhood.  The American Speech-Language Hearing Association recommends having your child's hearing further evaluated by a certified audiologist if you observe any of the following behaviors or symptoms of hearing loss:

-Your child is inconsistently responding to sound.
-Language and speech development is delayed.
-Speech is unclear.
-Volume is turned up high on TV, CD player, etc.
-Your child does not follow directions.
-Your child often says, "Huh?"
-Your child does not respond when called.

The importance of early identification of hearing loss in children includes:

- Receiving hearing aids (or cochlear implants) sooner
-Achieving their language and auditory potential
-Receiving early intervention
-Having parents who are informed!

Sometimes we just dismiss behavior indicative of hearing loss as a child having "selective listening" or choosing not to listen.  I've been there!  Recently my son was treated for severe wax impaction in both ears.  He is a typical 3 year old with selective listening and occasional defiant behavior.  After our pediatrician tried to treat the problem with little success, he referred us to the ENT.  Thankfully the ENT was able to remove the wax successfully.  But after seeing the severity of the impaction, the doctor informed me that my son hasn't been able to hear very well for the past couple of months!  Who knew?!

Sometimes it can be tricky figuring out if your child hears you well or not.  But the important thing to remember is if you have any doubt, get their hearing checked out.  The peace of mind will be worth your effort!
Wednesday, September 28, 2011

Imagination is everything. It is the preview of life's coming attractions. Albert Einstein

I love to play. Who doesn't? We all work for the weekend so we can relax and play. Even activities that we chose for leisure as adults help us unwind and recharge. Play does the same for children - it is a means for handling emotions, having fun, and learning in so many ways. 

We are a play-based company - dedicated to helping others learn about how play forms a child.  In preparation for a lecture we are going to be giving next year, I've been reading a wonderful book called "Einstein Never Used Flashcards." The book is authored by Drs. Kathy Hirsh-Pasek and Roberta Michnick Golinkoff and I am really enjoying it and recommend it for anyone raising or teaching children. The purpose of the book is to educate those working with children so that they can understand how a child naturally develops, how that development can be supported through play, and how and why we got to a point where our society values educational milestones so early in a child's life.  After learning this valuable information, adults can become empowered to make informed decisions for their children on choices from organized activities to toy selection.

One of my favorite sections of this book explores pretend play or imaginative play. This has always been one of my favorite types of play because it draws on a child's creative side.  In "Einstein Never Used Flashcards" the authors tell that pretend play has early beginnings with young infants in playing using symbols  - or symbolic play.  They state that at any place on the earth, symbols are used to represent things - both words and objects, so symbolic or pretend play is a basic necessity for all to learn.  This type of the play is also vital for language and social skills. I love an example they use to illustrate the progression of pretend play - or symbolic play. Their example looks something like this;

* 6-9 months - baby explores objects (often by mouth) to determine size, texture and other properties. A baby at this age would be doing this with a simple toy like a rubber phone.

* 23 months - that same baby might interact with the toy appropriately in a cause and effect type learning situation. She may push the buttons on that phone and hear a sound. She might also use something else like a hammer to hit the phone and make the same sound. Early play with objects like a doll (covering her up, feeding a bottle) are also common at this stage.

*3.5 years - At this age, toddlers are often pretend playing with small sets (like a farm and animals) but can use other objects (like that same old phone) for purposes other than their actual one. The example they provide is that the phone might be the cow's "baby."

We often see our children in single moments of time - a snap shot of today. Wouldn't it be interesting to catch them interact with the same 3 or 4 toys every 9 months or so and compare side by side how their skills change?  I find it fascinating that simple chewing on a play phone at 6 months old is a foundation for elaborate imagination journeys later in life. If you think hard, you can almost hear how that child's language skills progress as he/she plays.

When giving toy recommendations, my favorite piece of  advice for parents is to chose a toy that can be used at many stages of development and that don't "do it all" for a child - in other words a "forever toy." I'm also not a huge battery toy fan but that's besides the point! The perfect example is blocks. They could be used similarly to the example above...mouthing, throwing down to hear the noise, stacking, building a mighty castle, being driven as a "car," or playing the roles of two "friends" trying to decide what to do that particular day.

Looking back at my childhood, my favorite "forever toy" was a soft plain brown bear that was a gift from my sweet aunt to me in the hospital on the day I was born. I like to think of myself as a fairly creative person, but maybe that was a trait I acquired later on as I simply named him "Teddy." I'm sure that like the baby described above, I chewed on Teddy and threw him down (his battle scars are pretty convincing evidence). I remember wrapping him like a baby and dressing him in my younger brother's baby clothes.  He served as a security item and traveled with me many new places. He's even been to Europe and Hawaii and spent 2 agonizing days away from me lost in a church pew. I remember even as a tween using him to do gymnastics in front on me so that I could visualize how to do a new trick. He's ratty and worn, but he helped me learn many things, expand my imagination, and is now a reminder of many sweet childhood memories. 
                                                 A 34 year old well loved friend

Lots of childhood items dropped off here from my mother got trashed. Teddy made the cut. Apparently, he still has some magic. Tomorrow, in celebration of T week in Kindergarten, my daughter and her classmates will bring in Teddy Bears to have a sleepover in their classroom. Of all the fluffy, fancy, Build-A-Bear creations in this house of 2 girls, guess who landed the invite?  There is magic in a "forever toy" and in the power that imaginative play can bless a child with. So grab a huge box from your local hardware store and finger paint your dream house, line up the kitchen chairs and sit first class on your airplane, or open those dusty boxes and share your "forever toy" and your imagination with your little ones today.
Monday, September 19, 2011

Tips From the Trenches

I look forward every month to receiving my Parents magazine.  I enjoy perusing the pages for many reasons:  cute crafts, kid-friendly recipes, articles on discipline and medical issues.  But the monthly article I most look forward to is “It Worked For Me!”, where moms (and dads) send in easy, almost common sense, solutions to everyday problems or share their creative tips on everything from getting your kid to eat broccoli to potty training successes.

This month Parents is celebrating their 85th anniversary.  So in celebration of their milestone, they compiled 25 of their best “It Worked For Me!” tips for this month’s magazine.  There are some really good ones that I couldn’t wait to share with our readers!  So just in case you don’t receive the magazine or if you haven’t had time to read your copy yet, I sifted through the top 25 and created my top 10.  Hope you find something creative and practical to make your life and your family’s life a little easier!

*To prevent ice cream from dripping through the bottom of a sugar cone, push a marshmallow into the bottom of the cone.  It will soak up the drips and be a yummy surprise when the kids reach the end of the cone!

*To help motivate uninterested potty trainers, put a few drops of food coloring in the toilet bowl water.  Change up the colors so it is a surprise each time your little one visits the potty and before long they will potty trained and know their colors!

*To save your children’s artwork, laminate it and use it as placemats.  This can help you hold onto their masterpieces and give you back some wall space.

*Use bathtub decals, wrapped around the pedals of your child’s bicycle, to prevent his feet from slipping off.

*Use clean Frisbees, turned upside down, as your child’s plate.  The rim of the Frisbee will help them scoop and push food onto their utensils more successfully.

*To help your soap dispenser dole out the right amount of soap for little hands, wrap a rubber band around the neck of the dispenser so the pump will only go down half way.

*To help your child transition from the crib to a regular sized bed, put the mattress on the floor.  If they fall out in the beginning, they will only fall a few inches to the floor.  After a few weeks add the box spring, then the bed frame.

*To quiet an extra noisy toy, cover the speaker with painter’s tape.  The tape reduces the volume and it can be removed without leaving behind a sticky residue.

*Place a pool noodle, cut to the appropriate length, under your couch to block toys from getting lost.

*Store the baby wipes container upside down every so often to re-moisten the top wipes and keep the wipes on the bottom from getting too soggy.
Tuesday, September 13, 2011

What is your AFRICA?

Two daughters in school means a new season for this Mommy. More work, exercise, miss my children :), and reclaim some "me time." A goal that I've aimed for when this time in my life came upon me, was to participate in a women's bible study at my church. A time to recharge, renew, reflect, and have some time with ladies that I really value in my life. Our first meeting is tomorrow and to prepare, I used my coffee time this morning to read the introduction and first chapter of the book we are using.  The author introduces a story - his story - of what led him from a comfortable life as a CEO of a major company to working for a non-profit serving the most ill and poor in Africa. I could tell from the start of this book, that I'd be teary eyed during many readings and by the end of the first chapter was already asking myself similar questions that the author had asked himself, including what my role is in making this world a better place? How can I push myself to consider others beyond daily mundane routines? Where or what is MY AFRICA?

Surprisingly to me, I got my answers clear as crystal as the my day unfolded before me.  A young, single mom struggling with social issues and raising a special needs child. A separated parent needing encouragement. My children needing more patience than I had at the moment. One after one, I seemed to see what I was looking for without even trying. It may not be as glamorous as Angelina Jolie's international efforts or the author's of this book. I'm certain it didn't completely solve any one's problems that I encountered today or heal any deep wounds. But it was something I could give. If filling up an emotional piggy bank to help someone feel better could work, it was a few coins.

I felt inspired by what I read today to look beyond the things that had me sluggish and grumpy when I woke this morning (worry about a few people in my life, broken toe, cluttered house, carb-free breakfast if you care to know) and wanted to share with you. We all have something to give. It may not be hundreds of mosquito nets in Africa. It may be as simple as a smile to a stranger, an extra 5 minutes of hugs for your child at bedtime, free babysitting for a single parent, showing up and doing instead of saying "call me if you need anything," or an unexpected warm meal for someone who is hurting. What is YOUR AFRICA? What is our children's Africa? I believe that no mater what their age, they have something to give as well, and that they learn selflessness (what's that? It certainly isn't on many reality shows???) through our example. I learned from another parent and have passed on to my children the following words "you may be some one's only light today. Go Shine!" I use this often on their love notes in their lunches or in their ears with a goodbye squeeze before the bus pulls up.

Look around. I learned today that it's not that hard to find "AFRICA" all around you, whatever continent you live on! There are many emotional piggy banks that need filled around us -- how much change to do you have to give today??
Monday, September 5, 2011

Smart Shoe Shopping for Children

Two weeks into school, and while most of the back to school "to-do's" are checked off our list, I'm still searching online for school shoes. The days that my daughters can get by with their hiking style sandals are numbered and I need to purchase something.  I always have a tough time choosing shoes, finding it difficult to find something they like the look of, that I agree on, and that I feel will allow them comfort, function, and will last us through the year.  

As a physical therapist, I am often asked about shoe recommendations. I answer with a combination of information that I have gathered from research articles, experience, and other therapists that mentored me as a graduate student years ago.  The simplest way that I have found to explain the qualities of a good shoe are in this way. If you shut your eyes and stand on one foot, you will notice that your ankle and your foot make tiny movements to keep you balanced.  These movements, are balance strategies, and while they are occurring, tiny receptors in the muscles of the foot and around the ankle are sending messages to your brain to heighten awareness of your body's proprioception (where your body is in space).  With practice, your body improves it's "muscle memory" and when needed, your body can count on this muscle memory to prevent you from injury.  For example, when you step off a curb unexpectedly, and your ankle twists,  and automatically returns to upright, versus causing you to collapse on your side, this muscle memory has served you well and protected you. 

If you choose a rigid shoe for your child, they lose the opportunity for their feet and ankles to practice these balance strategies and for their arches to develop. If you've heard "barefoot is best" before, this is why. But we can't expect our children to walk barefoot outside and in the cold, so when you chose a shoe, you should look for a sole that can bend in half when you turn it upside down and can twist easily if you move it in the same way that you'd wring out a wash cloth. 

Not all of us can afford very expensive shoes for children, but knowing what qualities to look for give you guidance when shopping in any price range.  The exception to this rule is for children with lower muscle tone. These children often need a more supportive shoe, because their bodies do not provide adequate support on their own.  If your child has lower muscle tone, consult a physical therapist or certified orthotist for recommendations on orthotics and/or shoe wear.

When searching for shoes for my daughters, I came across a blog entry written by Dr. Mark Cucuzzella.  Dr Cucuzella is a family physician at Harpers Ferry Family Medicine in WV, an Associate Professor at West Virginia University School of Medicine, and the owner of Two Rivers (TR) Treads, the nation's first minimalist-only running store. He is also the race director of Freedom's Run, a wonderful growing charity race in my community.  The blog entry is a great source and specific explanation of shoe recommendations and overall orthopedic development in children. While I'm not officially representing or endorsing any certain brand of shoe, I think this information is extremely helpful and hope you find it as helpful as a mother as I did! Happy shoe shopping!

The full article can be found at :
Thoughts On A Proper Child’s Shoe
_RYA0192As a family physician, I firmly believe that children should play in their bare feet or in activity shoes that complement natural foot development and proper biomechanics of movement. Runners, walkers, coaches, and the medical community are all awakening to the benefits of allowing proper natural foot motion to occur in all of our daily activities. Leaders in the running mechanics, sports medicine, dancing, and yoga/tai chi communities all understand that the smartest design that will ever be developed for human movement and injury free activity is the human foot itself. Running shoe companies are slowly hearing this message and adapting their product lines to create footwear that allows your foot to behave like a foot, but most have only applied this new thinking to adult models. Unfortunately, the modern shoe industry and its marketing machine effectively convince parents that when running, a child should wear miniature versions of traditional adult running shoes; almost all of which have elevated heels, extreme cushioning, and some form of motion control technology. Many dress shoes for children are also stiff and overly supportive. Personally, as a doctor I firmly believe that the strongest form of support for a child is a strong foot that is flat on the ground.
infant feetHere’s an important point to keep in mind – a child’s foot is not a miniature version of an adult’s foot. In early development, a child’s foot is widest across the toes. If our population wore shoes that were designed with this functional shape from birth, most adults would also have feet with the greatest width located across the toes, and the toes would be perfectly aligned with the metatarsals (the long bones in midfoot). Most of a child’s developing foot is composed of cartilage, which is gradually replaced by bone. If the cartilage is deformed by badly shaped or rigid shoes, the bones will take on the deformed shape. More than 80% of foot problems, bunions and injuries are a result of misshaped and inflexible shoes. It’s vital that kid’s shoes allow enough room for natural growth, until the foot bones mature. This doesn’t happen until ages 18-19 for girls and 20-21 for boys. Simply put; inflexible, poorly shaped shoes are potentially harmful – they restrict the natural movement and development of the foot.
Research and education efforts from places, people, and organizations like the University of Virginia SPEED Clinic, Dr. Daniel Lieberman of Harvard University, and Chi Running are together allowing runners and walkers to re-look at old concepts related to form and footwear. More importantly, innovative shoe manufacturers such as Newton Running, Terra Plana Vivo Barefoot, Vibram, Kigo and newcomers Altra and STEM are now producing foot-friendly shoes that people can use to more effectively apply new concepts in their own self-experiments. It is hard to find a single one of the now thousands of runners and walkers who have made proper changes in their gait, and complemented this with footwear void of elevated heel/motion control features, who wants to return to the old way of heel crash pads and inefficient gait.
CIMG1601Currently, almost every running shoe company has products in development supporting natural running, and we are beginning to see the very first steps by many of them away from heavy cushioning and elevated heels. Again though, most of these new shoes are being made solely for adults. Outside of a few select brands, with Terra Plana Vivo Kids being the model (see the photo of the TP Pally to the left), a void exists in the development of proper youth footwear, where natural foot function and development are perhaps most critical.
Unfortunately, the medical establishment often fails to recognize what to many seems so obvious – a child’s foot is best off when it is interfered with the least. For example, without any supporting evidence, the President of the American Academy of Podiatric Sports Medicine (AAPSM ) David Davidson made this comment when asked about children’s footwear by Running Times MagazineKids should not be running in minimalist footwear at all, and as in other shoes, should be wearing brand name running shoes with good motion control, cushioning, etc…” I believe the opposite. I feel children should run barefoot as much as possible, and when they need a shoe, they should wear one that allows the young foot to develop its natural strength, support, and function. Parents should think twice before heeding the message that their children need “sturdy” or “supportive” shoes. As Dr. Lieberman demonstrated so well in his landmark paper in Nature (Jan 26, 2010), footwear can have a large influence on natural gait.
I find it highly unusual and there are no supporting documents to the APMA (American Podiatric Medical Association) parent flyer which states that parents should “Select a shoe that’s rigid in the middle. Does your shoe twist? Your shoe should never twist in the middle.” Curiously, right below that piece, and written in fine print, there is this accurate statement: “Step three does not apply to toddlers shoes. For toddlers, shoes should be as flexible as possible.” I’m left wondering “So at what time does a toddler become a child and we bind their feet up?”
IMG00258As a parent and physician I believe that the APMA statements could cause harm in a developing child's foot. A foot builds its own intrinsic support via communication with the ground, building strength and stability through proprioception, and allowing normal force loads to be applied to the areas that nature intended. If you change anything from what is normal in a developing child, then you proceed at your own peril. For example, when I was a child the APMA suggested bracing as a treatment for intoeing (feet that turn inward instead of pointing straight ahead) – fortunately this practice has been banned. The results were extreme tibial rotation and for me, I wound up needing patellar tendon realignments at age 13 due to completely misaligned tibia and patellas (kneecaps)....I missed a large portion of my high school running due to this.
A parent will almost always do what the experts say is best for their children, and the APMA statement that is mentioned above is one that I would challenge. Do I have studies for this....unfortunately, not good ones. Conceptual and evolutionary evidence is the best we have here. For one example, we see many high school runners with hallux valgus -- "big toes pointed in." Hallux valgus is generally caused by ill-fitting shoes with a pointed toebox. Furthermore, most runners, both young and old, cannot stabilize and balance on one foot. To run properly, you must be able to do this.
The next time you are in a park, watch a child run barefoot (see video below). Notice the relaxed movement and foot placement. They lean slightly forward and their legs fall out behind them. They do not strike hard on their heels. Then watch the child with the highly cushioned or supportive shoe. The difference is easy to see.
5yo Barefoot Running in Grass from Runblogger on Vimeo.
So what are the important features to look for in a child’s shoe?
· Ultra-thin soles to allow proper proprioception, neuromuscular activation in the entire kinetic chain, and to complement the body’s natural ability to absorb ground forces.
· Low, flat to the ground profile – shoes should allow all play activity that involves climbing, running, and jumping. Shoes should enhance lateral movement since the foot will not be up on a platform or have a slope from heel to forefoot.
· The materials should be soft and supple, thereby allowing natural foot function. The shoe should bend easily at the toe joints – this is where a foot is designed to bend to recreate the arch on takeoff. See the TR Treads website on Footwear Education for more on this.
· The toebox should be wide enough to allow natural toe spread (Runblogger’s note: check out this video of running toe splay on ground contact in my 5 year old daughter). Foot support is created by the natural arch of the foot with the great toe stabilizing the arch. When the heel is elevated and great toe deviated toward the second toe (a common design flaw in many shoes which come to a point), this stability is compromised. The foot produces the most leverage when the toes are straight and aligned with the metatarsals. A child’s foot is widest at the ends of the toes (as should an adult’s be if they have been in proper shoes or barefoot).
· A single piece midsole/outsole allowing protection on unnatural surfaces (concrete, asphalt) and natural rough surfaces (rock,trail) while allowing proprioception and natural dissipation of ground reaction forces.
· Upper material should be soft, breathable, and washable.
· Get over the notion that shoes need “traction.” In a moving child the more stickiness and grip, the more heat produced in the foot and braking moments on running activity.
· Discourage the use of thick, heavy socks as these interfere with foot proprioception.
· All efforts should be made to use recycled materials in the construction of the shoe.
· Shoes should be a good value and of comparable price to other children’s shoes.
· Design and colors should inspire fun and play.
· And critical is proper fit. For tips see the Two Rivers Treads Shoe Fitting Guide in their expansive Footwear Education section.
· For another great resource on children’s footwear, read this article by Dr. William Rossi DPM.
Why do I care so passionately about this? The most important reason is that I am a parent and want to do what is best for my children and not be influenced by marketing claims or trends. I have been a competitive distance runner my entire life and am personally involved in multiple projects and grants involving both youth and adult physical fitness. If we can teach proper approaches to pain free activity throughout life then the daily walk or run will be sustainable.
I had both of my feet operated on 10 years ago at age 33 for severe arthritis caused by a combination of improper gait mechanics, lots of hard miles as a collegiate and post collegiate runner, and the negative influence of new trends in footwear such as elevated heels and crash pads. The foot instability this created and greater impact in the great toe joint caused this joint to deteriorate. I had the joints fused in both feet and instead of taking the standard doctor’s advice of not running anymore, I chose to relearn how to run. I also got heavily involved in footwear design and function for runners and children. Read my story here on
IMG00260I have watched my own children dramatically change their movement patterns after discarding the heavy, inflexible “Sketchers with lights” and getting them into slip-on Vivo Barefoot kids shoes. They will not put anything else on their feet now when they need to have shoes. We gave away 180 pairs of Vivo Barefoot kids shoes at Freedom’s Run for our kids run thanks to the combined generosity of Two Rivers Treads and Terra Plana. See story….scroll down. Dozens of moms and kids have thanked me for the discovery they have made (Runblogger’s note: as do I – Mark was kind enough to send me a pair of Vivo Barefoot Kids Pally’s for my 5 year old daughter, and she and I both love them).
The beauty of this field is that it is evolving rapidly, we are all discovering new things, there is no one correct answer, and as a field we are doing the needed research. My personal results as a study of one give me the authority to say that you can retrain how you move, and that footwear does have an influence. I began running barefoot at the beach when I was 12. This was the beautiful movement that I can still remember. Thirty-one years later, I finished in the top 10 for runners over age 40 at the 2010 Boston Marathon in a time of 2:34. I’ve run under 2:35 for a marathon 22 of the last 24 years, with misses only during my medical intern year and in 2009 when I ran a 2:37. My training miles are minimal now for these efforts. Knowledge and application of gait principles and use of optimal footwear allows effortless movement to occur. It’s “no pain…thank you” instead of “no pain…no gain”.
It all starts with the children. Adults make their own decisions but children cannot. We need to see further collaboration among many fields – as Dr. George Sheehan so eloquently stated in 1975:
If athletes were given less care and more thought, the doctors might come up with some original ideas on why illness persists, why injury doesn’t clear up. If more non-physicians – podiatrists and physiotherapists for instance – could be induced to lend their ideas and talents, we might see a completely new approach to sports medicine. If the athlete had to wait longer for surgery, he might have time to recover from his ailments.
Footwear designers are a critical part of the future of preventive sports medicine, and they need to start thinking more about our children.
Long may you run…
Mark Cucuzzella MD FAAFP
Associate Professor of Family Medicine West Virginia University
Lt Col USAF Reserves – Coach/Captain USAF Marathon Team
Race Director Freedom’s Run
Owner of Two Rivers Treads- A Center for Natural Running and Walking

A few additional articles and websites of interest:
· Rossi- Proper Children’s Footwear
· Rossi- Fashion shoes….see page 10 and 11 of this interesting article
· Journal of Family Practice review of functional flat feet in children….this is NOT a disease needing treatment.
· Barefoot Parents Website
· Template for proper fitting of child shoe . Size up at least a half centimeter to allow for sock and foot spread
Medical Consultant for ChiRunning, Newton Running, and the US Air Force Marathon

Tuesday, August 30, 2011

Today I...

Today I….

took the time to paint my daughter’s toenails, at her request, minutes before the bus arrived.

rocked my son to sleep because he wanted me to.

taught a little girl three to new signs to expand her ever-growing vocabulary.

helped a one special little boy turn his not so good day into a better one.

was amazed by the persistence and positive attitude of a little girl with apraxia of speech.

These are the little things that happen in all of our lives, each and every day, if only we take the time to notice and appreciate them.  We are all so busy but slowing down has more rewards than keeping up the pace.  Take time to count your blessings today!

"A hundred years from now, it will not matter what kind of car I drove, what 
kind of house I lived in, how much money I had in the bank...but the world may be a better place because I made a difference in the life of a child." 
-- Forest Witcraft

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Welcome to our blog! As longtime friends, we recently decided to combine our professional experience (as a speech-language pathologist and physical therapist) and "Mommy Experience" to create a company dedicated to something we are both extremely passionate about - letting kids be kids! Milestones and Miracles, LLC was formed in 2010. Our mission is to empower parents in understanding the natural progression of their child's development (and not rush it along and skip stages). We develop and provide developmental products to support this learning process, bonding families through engaging, fun, and meaningful experiences! We are thrilled to share that our first product, 1 2 3 Just Play With Me is available for sale. Visit to learn more and order a unique product for yourself & your child or as a gift! We will continue use this blog to share about topics that interest and excite us. Stay tuned!


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