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Exercise physiology involves movement, play and the vagus nerve and pushing washing along the floor!

ROBYN PAPWORTH EXERCISE PHYSIOLOGIST - YOUTUBE RECORDING

Robyn Papworth is a paediatric exercise physiologist, developmental educator and trainer who is passionate about helping children’s body and brain to be ready for kindergarten and school through movement and play strategies.

Robyn reminds us that movement development can be fun and there are critical milestones that are part of a progression, not a race to deliver at a point in time. She share exercises we can do to help with visual tracking, core strength, crossing the midline, spatial awareness and shoulder stabilisation, all key elements to sit in a classroom and learn. She reminds us to connect feelings and visuals with letters, not to teach the ABCs. We need to meet the child with where they are at. If they need to throw toys off a table and see how it moves through gravity, offer them more of that in a fun playful way. Stack up cups and bowl them over or roll and tumble over some teddy bears. Setup play spaces that match your child's needs. Observe your child's sensory needs and match it. Is it light or darkness, noise or quiet or other things they need. Not every child needs a weighted blanket. And the best exercises for children with a trauma experience is exercises for the vagus nerve. They help when we have that sick feeling in the top of our chest. Simply blowing bubbles, singing and humming help. Its important to stimulate our 8 senses, yes not just 5, including propreoception (pressure), vestibular (balance) and interoception (inside sensations). Just spinning on a chair can help or playing with frozen toys or even just pushing a heavy basket of washing across the floor. Find out why by listening to the recording!

00:00 - Start 01:33 - Robyn's passion comes from personal trauma 03:18 - Milestones are a checklist of progress not a race to get to. Three things are critical to work on: visual tracking, tummy time and crawling. Looking at a board and then down at your page involves visual tracking and you need strength in your body to sit and just holding your head up is an action that works against gravity. Visual tracking, tummy time and crawling develop these critical skills 11:55 - Early intervention is critical but you can also do a lot from home to help the brain develop and start working on the top part of the brain, the pre frontal cortex. Fight or flight keeps us in the bottom part of the brain but the brain is plastic and can develop! 14:43 - School readiness involves learning 5 skills: visual tracking, core strength, crossing the midline, spatial awareness and shoulder stabilisation. 22:26 - Learning ABCs is not the focus. Learning about objects and where they are placed or what does a letter feel or look like is the concept they need to learn. 26:45 - Self regulation needs practice and includes three components: impulse control, movement control and emotional regulation. It doesn't come naturally to those from trauma. And for those kids that just want to throw blocks off the table, offer them more of it in a fun playful way. Tap into where they are at and provide what their body and emotions need. 31:31 - Play spaces need light and dark spaces so divide up spaces with low furniture. Observe your child's sensory needs and adapt the space to them. Not every child needs a weighted blanket. 34:52 - The best exercise when there is a trauma experience is working on the vagus nerve, running from the back of our cheek to the gut. It explains why we have that sick feeling at times. Things like blowing bubbles, blowing through a straw, singing, humming or buzzing help create vibrations in our mouth or throat that helps us settle. Hugging a ball helps our chest and monkey bars and tunnel ball are even better as we get stimulated by going upside down. 39:06 - The three senses we need to know about are those focussed on pressure (propreoception or where you give yourself a hug), vestibular (balance and car sickness) and interoception (inside sensations). Some important exercises include pushing a heavy basket across the floor when arriving home from school, spinning on a chair or playing with frozen toys. 46:26 - Exercise physiology is about coordinating movement and the motor cortex. Its right next to the sensory cortex. We may need help when bumping into friends or getting a mug to our mouth. 49:10 - Get outdoors to connect with visuals and smells and emotions and to different play spaces every day to challenge your body movement so it continues to learn and develop 51:27 - Remember where your child at now is where you need to start.

ROBYN PAPWORTH EXERCISE PHYSIOLOGIST - TRANSCRIPT

This is Sonia Wagner, representing PCA Families in one of our recordings that capture lived experience and best practice evidence based learning that assist kinship, permanent and adoptive parents/carers in supporting young people.

PCA Families has a zero tolerance of child abuse and follows child safe standards.

I would like to acknowledge the traditional custodians of the land and pay respect to elders past and present and express our intention to move together to a place of justice and partnership.

Today we are speaking with Robyn Papworth about movement and play.

Robyn Papworth is a paediatric exercise physiologist, developmental educator and trainer who is passionate about helping children’s body and brain to be ready for kindergarten and school through movement and play strategies.

Robyn has had her own experience of early childhood trauma and has lived experience of parenting a child with dyspraxia, a planning and movement disorder which makes skills such as catching a ball, getting dressed, holding a pencil more challenging to learn and master.

Robyn can help with what to do when you have questions like these that are often overwhelming for parents and carers:

  • What to do next if my infant isn’t walking by 24 months?
  • If my child is tripping over frequently or is clumsy with their movement
  • If my child is finding it difficult to focus and regulate their body and emotions at kinder
  • How to support my primary school aged child in learning to read

01:33 Welcome Robyn. So where does your passion for the work you do come from?

It’s come from my own history and my son. I used to work in aged care as an exercise physiologist with people with Parkinsons, Stroke and Dementia. And when my son was born and he has been delayed with all of his motor skills up until this point so I helped my son. Through helping my son I have then helped children all around the world.

With regards to the trauma space I just get it. I remember being recruited by DHS years ago and in this report it said this little fellow they may struggle to connect with you. For this little fellow we just connected. I wasn’t afraid of him and so he wasn’t afraid of me. He could see the crazy clothes I wear.  So that’s what I am passionate about.

No judgement. If a strategy works it works. If it doesn’t work reach out and we can try and find something different. Every child is different. I’m different. Its a completely open space where we can chat about movement and play without judgement.

03:18 How do parents and carers know what milestones to look for in their children in the early years (from 0-5)? Can we discuss the important ones?

The Maternal Health Checks are important not to miss. Please I encourage every family. If you miss it just catch it up. Know that this checklist is just a guide. My son and daughter were born one minute apart as twins but he was sometimes 18 months behind on the checklist in some areas. Does that make him any different or any less than his sister. Absolutely not.  It just shows us on the checklist there are certain areas that are important to progress through. Its not a race to get to each checklist.

You see it in categories 0-3 months and 3-6 months. Please know it is a pattern. If your child has not reached it by that 3 month mark, its ok we just need to work through that pattern.

Visual tracking is number one. When a baby is born it will ideally look up at you and goo and gaa and be all cute and look around the room to see what is happening around the room. Visual tracking for children from trauma is even more important. For my situation I came from neglect so I wasn’t getting that visual tracking. I don’t know why I wear glasses now but in my profession I attribute some of it to the early period. I didn’t have that environment that encouraged me to look up at to look around my space for my family members and caregivers. Just like everything else visual tracking is a movement we need to practice.

If you have a child in your care and you are noticing that they are not looking up and not connecting, don’t make them connect with intense eye contact. Setup a lot of fun visual tracking activities. I would put pictures on the wall and get the children to swat the pictures with a fly swat or throw some socks at the pictures on the wall. We make sure some of the pictures are above and below our head so we are looking all around the room.

Visual tracking is a skill that kids with autism sometimes lack. Eye contact and looking up at our caregiver may have been missed. That really important looking up phase. So what that looks like in school is they are not able to look up at the board and look back at their paper easily. Visual tracking is number one.

If you are looking for any of these words too and you think that’s exactly what I need, go to my facebook page “Play, move, improve” and type in “visual tracking” and I’m always sharing free ideas and activities.

The other key milestone is tummy time and laying on the tummy. Children like my child who has dyspraxia or children who are born through c section or children who were sitting up in strollers for a long time and not getting that movement can be quite floppy in their body. Its not their fault that we carry. My son struggles with these skills but that’s not my fault. Sometimes we are reluctant to help because we take that blame on ourselves. Please don’t take on the blame. Please just know the brain is an amazing organ that can always improve. We just need more tummy time activities. You can lie on the floor and roll a ball back and forth. You can do that straight away even as a newborn. With a newborn they need to hold their head up so they don’t get smothered and I never put a blanket down beneath them. For newborns you can also do it with them lying down on you as you lye down on your back. This is also relevant to teenagers. We don’t do silly little games with our teens. For them we might use their screen time. We don’t take away their screens as that can be disastrous but we get them to do a short period of time on their tummy while they are talking to their friends.

Crawling is really important too.  Before we worry about sitting or walking, we really want crawling to be in here. Its really around 12-18 months for crawling as it is a really challenging motor skill to learn. They have to hold their head up and work against gravity. So its quite a complex process. 

I was born C section as well and some c section babies have this problem. Also culturally if you are carried around a lot.  Also the oldest child might be carried around a lot.  The youngest child can sometimes be more independent with their movement.

So start with those three visual tracking, tummy time and crawling.

11:55 We all know that early intervention therapy, services and strategies are critical to the best outcomes. Should our expectations differ for children who have come from a disrupted or traumatic childhood?

If anything I would encourage more of these things. The system is hard and waiting lists are hard so Im really passionate about giving these quick tips and strategies.

If you think of the developing brain we develop our brain from the brain stem, from the  bottom up. Even me Im still working on it I have my own therapy team working on the pre frontal cortex area. With trauma with neglect and survival we sit in the bottom part of our brain so we need strategies and therapy to build up the top part of our brain in the pre frontal cortex. The part that has impulse control and self regulation and expressing our emotions. So I encourage all children from trauma to be involved in early intervention.

There are so many therapists around. We are all an allied health team. If you have trouble with your speech pathologist they might say for this are of development we go to an exercise physiologist or an occupational therapist. The earlier the better when the brain is growing and developing and is more plastic. We can leave it to later on too. In my generation when I became a troubled teen people started to do something.

Its great how everyone can share and direct to the right resources. Allied health people are not scary. We are finding the gaps.

14:43 Talking about school readiness, can you tell us about the 5 skills you mention that you need for school?

Visual tracking again. To be able to read we have to be able to move our eyes. If we have poor attachment or poor connection we may want to shut out sometimes. So we may not be able to track and look around our environment.

Core strength is the other one and that’s why tummy time is so important as a baby and an infant. When I am sitting at a table I need to be able to sit like this. If I don’t have the core strength to sit up at the table everything becomes exhausting.  Even if I’m sitting at mat time, if I can’t sit up the day then becomes very fatiguing. Good news is our school work can be done on the ground or in a swing. It doesn’t have to be done at the table.

Crossing the midline is another skill. There is a part of our brain called the corpus collosum. It’s the bridge that brings the right and left brain together. It allows me to brush my teeth on the opposite side of my body.  It allows me to write my name on the top left side of the page. It allows me to put my jumper on. It allows our left and right sides of the body to work together. What we see with children of today is we aren’t as active as we were a few years ago so we aren’t doing as much climbing, crawling, rolling around outside. Screen time is very much in the middle of our body using one hand. This skill requires using both hands. I bring my right hand up and tap my left knee and vica versa. When a baby calls they reach with their left hand forward and their right knee come up. That is why karate, dance and gymbaroo are important.  Access activities like that which are beneficial for the body.

Spatial awareness or relationships is another skill that develops after the age of 2. I have two objects here and I want children to tell me the distance between each other, close and far away, because when we are out in the yard we want children to learn oh you are really close to your friend can you move a bit further away. They learn concepts in play first. They then learn maths concepts like on top of, underneath, in front of, behind .and next to. These concepts are really important for maths. If you imagine the number 2 in front of the number 5. Or fractions we need the number 1 above the number 2. So if we don’t have these concepts then we get to these words coming at us at school and we don’t know what they mean. So with objects we just play games like that. I want you to put the teddy bear on top of the table. The teddy bear goes underneath the table. Those concepts in play makes it less stressful. Also out in the yard I want you to wait in front of Harry for example. I want Sally to wait next to Harry – different concept. So that is where we see some of the challenges in school because we are confused by these really simple space concepts. 

Having twins we are still working on those concepts for one of our 10yo.

Shoulder stabilisation is the last one. So being able to keep the shoulders strong without flopping. It’s a fine motor skill activity like hand writing, doing up buttons, opening up a snack box etc. Anything where we take our body weight through our arms. Climbing a pole or ladder, crawling, rolling all builds up shoulder stabilisation. We do these skills before holding a pencil or using scissors. If the main part of our body isn’t strong enough we cant hold a pencil and do all those other things. So slides and climbing frames are important.

22:26 Many parents and carers can become preoccupied with teaching the ABCs thinking that it helps with reading. I know you are passionate about motor skill development for reading. Can you tell us more about that?

I think its cultural and it can show the success of a parent or teacher.

I hear families asking me what reading level is your child at. I think don’t worry about it. It’s all about progression. Reading level is exactly like those checklists. It doesn’t matter if they walked by 13 months, or crawled by 11 months, we sometimes get stuck in the months of the reading level. Its about progression. Are they better6 weeks past. Are they better this time compared to last time and is the brain learning and progressing. That’s what we are trying to encourage in the education system. The education system pushes curriculum. Sometimes a parent will go for a school that has better data. But that does that mean that our child is going to be well rounded in the future. Who knows.

I do a system where it is a tick a dot and a star.  We have achieved the goal tick, I couldn’t do it yet a dot, the star is where I need a bit of help. In 6 weeks they may not be able to crawl but they might be able to do it with less help. So with reading, are they are to do more identifying letters or more letter sounds than 6 weeks ago.

With reading, the concepts of putting an object one in front of the other is important. I often do b, d, p and q and that drives children crazy.  If I flip a b in front of a mirror it’s a d. If I flip it upside down it’s a p. When I turn this pen upside down and round and round its still a pen. But when I move these 4 cheeky letters, they change their name and their sound. So what I do is Id rather they know what their body feels like than what the letter looks like. I go ok the letter has a big long stick and a big fat tummy and the tummy is on the right. We start with those concepts. Which side is right. Which side is top and which side is bottom. We start with those concepts and have fun. Even those games on the wall with a fly swat, rolled up socks, having fun, rather than lets read this boring book over and over again. Its special awareness and visual tracking for sure.

26:45 A child’s social and emotional development can be improved through play. However, self regulation can be challenging for our families. Can you help us understand how we can help with self regulation?

Self regulation is a skill we need to practice just like crawling or throwing a ball. Some 44 year olds struggle with that. So we need to practice and master. Play gives them that opportunity to practice and master.

There are three components. Impulse control, movement control and emotional regulation.

Impulse control: Can I stop myself from not wanting to crash that tower or take that donut off the bench.

Movement control: Can I coordinate how rough or how gentle my movement is.

Emotional Regulation: When I’m frustrated can I identify it, manage it and go along with it. When you come from trauma it does not come naturally. You need to practice it. I have to do beautiful vagus nerve activities. Not vegas as in las vegas. It settles the nervous system down so we can self regulate. A lot of our little ones are in fight or flight all day. Even myself. There are zones of regulation where you colour your arousal or energy levels. I don’t think Im ever in calm or in the green zone. So we have to learn this skill and it takes practice and time. In play we do a lot of turn taking. So I play a game where we stack a tower with blocks and I take my time with putting a block on and they need to wait. We work on it slowly and we talk through it  “I can see that your hands are getting tight” and “I can see that you are getting frustrated”. We also talk about the beautiful part of teaching your brain to wait. At school we need to wait sometimes in the line.

Some children will be stuck in the play where they just want to throw the toys off the table and see how it moves through gravity. That’s different to impulse control. For children that like to swipe things off a table or watch things crash. for those children I provide more of that. The play and rough and tumble. So I set up stacks of plastic cups for them to roll down. Or stacks of teddy bears and we roll our body through the teddy bears and crush or throw the teddy bears out the way. So we give it to them in a playful way.  When we find out where they are at, tap into what they need and what their body and emotions need you get a different outcome compared to trying to battle it.

31:31 I understand you help with practical ways to setup a play space. Can you teach us?

Again what I do with a child is I see what they need. What their body and their brain need. We observe their play to do that.

A child may come in with a hoodie over their head and they want sunglasses and they want everything dark. That’s me. I turn the light on for the camera but otherwise I live in darkness. We have to make sure there is a space for that. So a fort or a tent for that. A pocket of space where they can climb under a table or find a dark space and be comforted.

With multiple children in a space you of course may have another child that needs bright lights and everything bright and sensory. So we have another zone for that.

I like to divide rooms with an ottoman or a small low shelf. We can still see over and see they are safe and observe the children but the children cant see over that because they are smaller. They will feel like it is separate and cosy.

Resources need to match the child. Ive just done my interior design course because Pinterest and others are showing all these spaces and designs. But does my child need that. Just because your cousin has a weighted blanket, does your child. We always have to adapt the environment to your child. Sit back and watch your child with their sensory hat on. Are they avoiding brightness or big loud sounds or are they seeking brightness or rough and tumble and throwing things up in the air. Adapt the space to them so it suits them as much as it possibly can.

Darkness might even be wearing a hat inside. Leaving the light off when you walk in a room.

34:52 What are some of the best exercises you think every parent or carer should offer their child?

Knowing what you do I am going to give you very specific vagus nerve exercises for those children in fight or flight. If you were a kindergarten teacher I would give you another set of examples.

The vagus nerve goes from behind the back of the cheeks (cranial nerves) all the way from the back of your face to your gut. When we feel sick that we can’t eat, that’s the vagus nerve not happy. The sympathetic parasympathetic nervous system isn’t happy. The nervous system is the fight or flight. For me I’m very vocal when under attack. I was in fight a lot of the time. Hence the troubled teen because I was very vocal as a troubled teen. A lot of other children will flee or hide in flight. Its important to bring in this vagus nerve parasympathetic nervous system. Its our rest and settling nervous system to turn that fight or flight off.

You start at the top of the vagus nerve at the top of our face and play fun games like blowing bubbles. Then a child will start to settle. They are creating pressure in their mouth and stimulating the vagus nerve. Blowing through a straw and blowing a pom pom across the table, is pressure in the mouth stimulating the vagus nerve.  For children that get dropped off at kinder or school in fight or flight. Give them very cold icy water through a straw as it stimulates the vagus nerve when we give it really cold temperature. That’s why you see women with ice blocks as it settles down the nervous system. Really icy cold water through a straw. It doesn’t sound like movement but we want to help our children settle first.

Another thing we like to do is sing or hum as it creates vibration in our throat. That’s why yelling feels good but we need to do something more appropriate like singing, humming or buzzing. That all creates vibration in our throat and stimulates the vagus nerve.

If I cuddle myself or a ball we move down to the chest area.  Even better when we go upside down. So playing things like tunnel ball we get stimulated going upside down. Monkey bars and rolling down the hill stimulates the vagus nerve. Just do one of these every day to settle the vagus nerve.

39:06 There are more sense than the ones we know about (smell, sound touch, sight, taste). Can you tell us about the other three systems and why they are important?

Propreoception- that was when I gave myself a hug. Think of it as pressure. It’s the feeling of going into the fetal position or throwing things across the room. What we need to do is provide it in an appropriate way. Sometimes they are great at school but when they come home things go astray. Have a washing basket at the front door with heavy books in the bottom and get them to push it as far as they can through the house. We get a few things. Propreoception with pressure to push something heavy along the hallway. We also get vagus nerve because we are tipping our body forward. That simple thing of I need your help I cant get the washing basket to where it needs to go. It may not take away all of it but it might be enough to reset.

The vestibular system is about our inner ear that causes vertigo for some of us as we get older, or car sickness or boat sickness. When it works well it allows me to move my head left and right, Im adapting my shoulders so I don’t fall over. When I put my head forward I don’t fall over. For our children who spend a lot of time on screens. Again big word search it in my facebook site for exercises – lots of free ones.

Lots of rolling for the vestibular system as he goes in a 360 degree movement. He didn’t like it at the start and saw it as punishment. Even on a desk chair spinning around where my eyes have to adjust so I don’t fall off the chair. Even after screen time its time to roll or does these activities. My son has two or three of these activities a day working on their goals. My oldest daughter she is more of an introvert so we do meditation as part of our normal routine to help her settle and refuel herself after the busy school environment.

The eighth sensation is interoception. That is the ability to understand what is happening inside our bodies. An internal sensation. It tells us when we are hungry or thirsty or need to go to the toilet or are hot or cold. If my heart rate feels an increase it’s a warning sign that I need something. Its very difficult for children from trauma because they have often turned off and disconnected from their body for survival. So we need to teach how to reconnect with our body.  Some simple tips is playing with different resources, one being icy cold. You can even put their toys in the freezer. Pencils and icy blocks. Which one is warm or cold. What does it feel like when it is cold. Yuk, nice, hot. Given them language to connect with it. Get them to use a word or something to connect with it. Similar to when we bake in the kitchen. Which one feels slimy which one feels warm which one feels cold. Hot is too dangerous with children. I use cold and warm as its safer. As they get older we can provide them with a nice cup of decaf tea and ask them how it feels. But I don’t test that with children.

Other things we do when its hot. With some children they will wear a jumper at summer time. Or they can be in a singlet and shorts in winter. We want to talk about describing words. I can see that your cheeks are really rosy. I can see that your lips have gone blue. We hold them to a mirror so they can connect with that and see that.

46:26 What is some of the science sitting behind spatial awareness, balance and motor skills or exercise physiology in general?

Exercise physiology works the motor cortex. Its the side that coordinates our movement. How to pickup my mug and get it to my mouth. How do I craft my hand to hold the sand. Right next door to the sensory cortex. They sit right next to each other. Its how we know ouch I’ve touched the stove and pulled my hand away. Or Ive bumped into my friend. Sorry recorrect my balance and I wont bump into my friend anymore. Its all about getting the information from our play space and how our movement coordinates with that. Sometimes its confusing who sits where. Exercise physiology is is all about providing you with the exercises to do. Physiotherapy and chiropractic are a bit more hands on. Its all about self management with exercise physiology. We are more about what to do with your own body. Occupational therapy is more about the environment and providing the right resources. We blend a lot. Find the allied health person that best suits your child or the person you are caring for. Im very neuro based about the brain but other exercise physiologists are all about the muscles and ligaments and heart and diabetes. Every exercise physiologist will not be the same. So always when I make a call to an allied health professional I ask what is your specialty or who are the parents you help. We all have a specialty and we cant know everything. And don’t feel afraid to say no to one professional over another.

49:10 I know you are also passionate about outdoor, nature and sensory play. Can you tell us why?

If we aren’t giving our body sensation, then we can’t have coordinated movement. I know this as I used to work in an area of Melbourne where everything was urban, concreted and flat. I was noticing differences in balance to where I live now in the Yarra Valley where its very hilly and mountainous. Very different children’s balance skills just from environment. In a flat environment we don’t need to challenge how we move and coordinate our body. WE don’t have potholes to navigate or big hilly driveways to walk down or up. That’s why I love these programs that are out there now like bush kinder. You can be in an urban kindergarten but you go out and have these bush experiences. I encourage play in nature after school, on a weekend. Just plan out a different play area or beach and get them to explore all different environments in nature. What I like about nature as well is, especially for those that have come from trauma, is that it helps us to reconnect in. If I stay in this calm space that’s where my brain will stay. But if I get out and feel the breeze and the sun and smell the flowers and the ocean, I feel more connected with me. Its very important for movement and for self regulation and for emotional regulation. You don’t want to push a child to meltdown but its very dangerous to always stay in our comfort zone.

51:27 Is there anything else you wish to comment on today?

I apologise for throwing a lot at you. Where you child is at now is where we need to start. Don’t worry about where they need to be. As you know my 3 children are all at different stages, strengths and all have different challenges. We don’t compare them with each other but we just have goals every day based on where they are at.

Reach out and feedback if something works or doesn’t. That’s what I love.

Thanks Robyn.

OTHER RESOURCES

Play Move Improve Facebook Link - (20+) Play Move Improve | Facebook

Skills for School Readiness - What motor skills do children need for school? – Play Move Improve

NDIS Funded funded (capacity building) custom home exercise physiology programs -  NDIS Custom Home Exercise Physiology Program – Play Move Improve

Child Development Podcast - Podcast – Play Move Improve

Self Regulation through Movement and Play - Self-regulation through movement and play online training document – Play Move Improve

Robyns video on why she is passionate about exercise physiology -