Movement and Mindfulness Physiotherapy for Children

Fitness, coordination, mindfulness and attention training for children  

Skills for Action Movement and Mindfulness Physiotherapy (MM-PT) recognizes that many children with movement conditions also have co-occurring emotional and cognitive self-regulation difficulties that interfere, not only with learning of new motor skills but also impact on function and participation at home and at school. In order to address the many different facets of a child's abilities, MM physiotherapy combines fitness and coordination training with mindfulness and attention training.

Combining mindfulness, attention and movement training provides a way to intervene at two levels of brain function and behavior: 

Bottom up reactive processes that provide the background for action: both fitness training and mindfulness practice have been shown to moderate the reactivity of the salience networks of the brain (including amygdala and insula). Heightened activity in these structures are often a major contributing factor to childhood behavioral difficulties, including fearfulness, avoidant behavior and heightened negative reactions to sensory inputs. 

Top down controlled processes that are harnessed and improved by training goal directed task based actions which that engage the child's cognitive self-regulation processes (goal planning, inhibition, mental flexibility, sustained motivation, executive control, and self-agency) in the pursuit of achieving goals and experiencing success. 

Movement and Mindfulness Physical Therapy and difficult behaviors 

  • Sensory over-responsivity - due to heightened reactivity of the salience network
  • Negative responses to strong sensations from the body (anxiety sensitivity)
  • Meltdowns and tantrums related to being overwhelmed
  • Avoidant behaviors used as a way to get out of task that appear threatening or difficult 
  • Tendency to negative self-appraisal, poor tolerance of error, and prefectionism 
  • Hyperactivity in response to novel situations
  • Fear of injury - including fear of heights and falling 
  • Becoming overwhelmed by new or unpredictable situations 

Training fitness, flexibility, posture  and coordination 

Movement and Mindfulness Physiotherapy uses a task based, context oriented approach to improving a child's ability to perform the many movement based tasks that are important in everyday home life, in the classroom and playground and in the community. 

Movement and Mindfulness Physical Therapy Intervention Strategies

  • Routines based assessment of daily function and participation
  • Collaborative goal selection and setting 
  • Task based fitness and coordination training which addresses impairments, function and participation
  • Careful attention to flexibility using active mobilization 
  • Mindfulness training combined with attention games 
  • Use of a ful range training principles/approaches to enhance engagement and learning 
  • Therapists understand the impact of poor emotional and cognitive self-regulation on motivation and learning
  • Select training tools, feedback and reward strategies appropriate to the individual child

Parent-as-trainers approach 

  • Providing parents with the information they need to understand their children's difficulties in a comprehensive manner
  • Helping parents to find ways to incorporate training into daily routines
  • Modeling behavior enhancement strategies 

Why pay attention to attention and emotional and cognitive self-regulation? 

Many children with movement difficulties, including those with joint hypermobility, developmental coordination disorder, developmental delay, handwriting difficulties and those on the autistic spectrum have co-occurring difficulties related to effortful control, attention moderation, emotional and cognitive self-regulation, sensory over-responsivity, and a variety of other  behaviors related to having a inhibited temperament (BI) as well as anxiety and conduct disorder. 

In turn children with language, attention, anxiety and conduct disorders often have coordination difficulties (DCD) as a co-occurring condition. 

Learning and improving movement based tasks requires motivation to put effort into practicing a task, persistence in the face of failure, use of effective self-appraisal to recognize and acknowledge success, exploration of different ways to achieve a goal, staying on tasks and following and remembering instructions. 

Without good emotional and cognitive self-regulation learning is hampered and ceases to be fun and challenging. Motivation is poor and children fail to improve their sense of self efficacy and a I-can-do attitude to take on new challenges. 

Recognizing and addressing emotional issues and poor self regulation allows the physiotherapist to understand the child better and adapt training sessions and advice to meet the child's needs. 

M&M principles and a parent led fitness program 

The SfA Fitness and Coordination Training Guide  provides a range of ideas and instructions for putting together an effective parent led fitness and coordination training program for children. 

Starting a fitness and coordination program for your child, even if it is only 15 minutes a day has many advantages:

  • Setting goals, working at a task and achieving success motivates a child to put effort into other tasks and improves self confidence
  • Setting aside dedicated time for one-on-one interaction with your child is a great opportunity for learning how to help your child stay on task and pay attention
  • Setting goals together, and helping your child learn that with support desired goals can be achieved, will change your child's sef-efficacy. 
  • Setting goals that can be achieved in a relatively short period of time increases you and your child's sense of what is possible.