Have you ever watched your child slide out of their chair like a melting popsicle, twist into a pretzel during homework, or tumble off their seat for the third time in ten minutes?

Congratulations your child is a perfect candidate for adaptive seating.

Across Chicago, families are discovering adaptive seating as a simple way to help their child sit comfortably and stay engaged.

These specially designed seating solutions meet the unique needs of children with disabilities.They provide support and stability for proper positioning and improved focus.

The goal of adaptive seating is to assist children in maintaining a comfortable and functional position while sitting for extended periods of time. It can also help to prevent falls or injuries caused by instability.

At Blue Bird Day in Chicago, we have over a decade of experience helping children with sensory, motor, and postural needs find seating solutions that support their bodies.

Adaptive seating is a simple solution. There are many benefits besides the seating being just so much more comfortable. It supports posture, stability, attention, and participation all at once.

When children feel physically steady, their bodies can relax, their focus sharpens, and they can engage more fully.

This is especially true for children with sensory processing differences. Good seating alignment supports the spine and pelvis, which builds healthier posture and muscle development.

Our team works closely with each family to select the seating option that best matches their child’s unique sensory profile, postural needs, and daily routine.

There is no one-size-fits-all answer. That’s exactly why we take the time to get to know your child first and try different seating options at Blue Bird Day.

This guide explores what adaptive seating is, the role it plays in promoting proper posture, why posture matters so much for growing children, and how you can use simple, therapist-approved strategies to support your child’s sitting posture at home.

If you’d like a  personalized insights, please contact us today. We’re here to support you every step of the way.

What is Adaptive Seating?

Adaptive seating refers to specialized chairs, cushions, and supports that provide extra stability and postural control for children who have difficulty sitting independently.

This includes children with physical disabilities such as cerebral palsy or spina bifida, as well as those with neurodevelopmental conditions like autism spectrum disorder, sensory processing disorders, or ADHD.

The goal of adaptive seating is to assist children in maintaining a comfortable and functional position while sitting for extended periods of time. It can also help prevent falls or injuries caused by poor posture or instability.

Adaptive Seating Options: Features, Benefits, and Where to Find Them

Options can include:

• Footrests to give the feet a firm place to rest
• Wedges to gently tilt the pelvis and encourage an upright spine
• Lumbar rolls to support the natural curve of the lower back
• Trunk supports to keep the body aligned and reduce leaning
• Elevated seats to create proper hip and knee angles
• Floor-sitting adaptations for play and circle time

The goals of adaptive seating are to:

• Improve posture and body alignment
• Reduce fatigue during seated tasks
• Support core and pelvic stability
• Strengthen attention and engagement
• Promote safe, comfortable participation in daily activities
• Help prevent long-term strain on muscles and joints

You’ll find adaptive seating used in homes, classrooms, therapy centers, and community spaces. It’s especially helpful for children who work a little harder to stay upright.

What Does Optimal Posture Look Like?

“Sit up straight” is advice we’ve all heard, but optimal posture is about much more than a straight back. It’s a balanced, well-supported position that lets the body work smoothly without strain.

When a child has optimal posture, you’ll usually see:

• An upright spine with a gentle inward curve in the lower back
• Head, neck, and shoulders lined up over the hips
• Relaxed, lowered shoulders (not hunched up by the ears)
• Elbows resting comfortably near the sides
• Hips and knees bent at about 90 degrees
• Feet resting flat on a firm surface
• A neutral or slightly forward-tilted pelvis

When children reach this kind of balanced posture, wonderful things happen. They can:

• Breathe more easily and deeply
• Use their hands more effectively for writing, eating, and crafts
• Pay attention for longer stretches
• Take part more fully in learning and play
• Feel less tired and uncomfortable

Why Posture Matters for Children

Posture touches nearly everything—breathing, attention, even how a child feels emotionally. When a child doesn’t yet have the core strength or stability to sit upright, their body finds ways to compensate. Those workarounds can lead to discomfort, distraction, and frustration.

Here’s why good posture is worth your attention.

1. Core Muscles Support Upright Sitting

The muscles in the belly and back work together like a team to keep the body upright. When these muscles are weak or tired, children tend to slump, lean, or slide. This isn’t a behavior problem, but a body that needs more support.

2. Poor Posture Can Lead to Discomfort

When the core isn’t doing its share of the work, the body leans more heavily on bones, joints, and ligaments. Over time, that extra load can cause strain and aches.

3. Posture Affects Breathing

Slouching squeezes the lungs and limits airflow. Upright posture, on the other hand, allows for deeper breaths and better oxygen flow to the brain. More oxygen often means sharper focus and easier learning.

4. Stability Supports Attention

Picture trying to concentrate while constantly catching yourself from sliding off a chair. When a child feels physically steady and supported, they can pour their energy into the task in front of them rather than the effort of staying upright.

5. Posture Shapes Social Engagement

An upright posture helps children lift their heads, make eye contact, and connect with the people around them. That steady foundation can make group play and conversation feel more natural.

How to Improve Your Child’s Sitting Posture at Home

If your child struggles to stay upright during meals, homework, or play, a few thoughtful adjustments can make a real difference. Below are simple, therapist-approved strategies you can try at home using items you likely already have. As you read, remember: every small change is a step toward your child’s comfort and success.

1. Foot Support

When a child’s feet dangle and don’t touch the floor, their body has to work much harder to stay balanced. Unsupported feet often lead to wobbly, unstable posture.

Try this:

• Place a sturdy shoebox, plastic bin, or small stool under their feet
• Make sure the surface is firm and won’t slide around

Why it works: Giving the feet a stable base increases overall stability, reduces fatigue, and frees up your child’s attention for the task at hand.

2. Wedge Support

If your child slouches with rounded shoulders or a head that drifts forward, a wedge can gently tilt the pelvis forward and encourage a more upright spine.

Try this:

• Use a wedge cushion designed for seating
• Or fold a towel or small blanket and place it under their hips to help shift their weight forward

Why it works: A forward pelvic tilt sets off a helpful chain reaction up the spine, supporting better alignment from the hips to the head.

3. Trunk Supports

If your child leans to one side, collapses forward, or works hard just to stay centered, trunk supports can ease the demand on their core muscles.

Try this:

• Choose a chair with a higher back
• In a chair with armrests, tuck pillows or rolled towels along the sides of the seat

Why it works: Trunk supports help children hold their alignment without overworking muscles that may still be developing.

4. Lumbar Support

Children with lower core strength sometimes have trouble keeping the natural inward curve in their lower back, which can lead to slumping.

Try this:

• Roll a small towel and place it behind the lower back
• Position it slightly higher than the hips but below the waist, where the spine naturally curves

Why it works: Lumbar support encourages healthy spinal alignment and helps reduce fatigue during longer seated tasks.

5. Elevating the Seat

When a child’s hips and knees bend more than 90 degrees, they’re more likely to slump or lean.

Try this:

• Swap the short chair out for a taller chair
• Or raise your child higher with a firm cushion, a folded blanket, or a few large books so their bottom and thighs are at the same level

Why it works: Proper hip and knee angles support pelvic alignment and help the core muscles switch on.

Tips for Floor Sitting

Floor sitting is a natural part of childhood, from circle time to building blocks and reading on the rug. But it still calls for good posture! Children may sit in:

• Ring sitting
• Tailor sitting (“crisscross applesauce”)
• Side sitting
• Long sitting (legs stretched out front)

No matter the position, optimal posture still includes an upright spine, aligned head and shoulders, relaxed shoulders, and that gentle inward curve in the lower back.

Try this:

• Slip a wedge, pillow, or folded towel under their hips
• Slightly elevate the sitting surface to tilt the pelvis forward

Why it works: Just like in a chair, a forward pelvic tilt helps support an upright, comfortable posture on the floor.

Without Wedge vs With Wedge

Ring Sitting

Tailor Sitting

Side Sitting

Long Sitting

Who Benefits from Adaptive Seating?

Adaptive seating can help many children, but it’s especially supportive for those whose bodies work a little harder to stay upright. Chicago families often turn to adaptive seating to help their children:

• Stay engaged during meals and homework
• Take part more fully in school activities
• Build posture and core strength
• Reduce fatigue and discomfort
• Support sensory regulation
• Grow more independent
• Connect more easily with others

Adaptive seating tends to be especially helpful for children with:

• Autism who may experience sensory or postural differences
• ADHD who benefit from added physical stability to support focus
• Sensory processing differences that affect how the body responds to position and movement
• Low muscle tone that makes upright sitting more tiring
• Motor delays that affect balance and coordination

Every child is different, and the right seating support depends on your child’s unique strengths and needs. At Blue Bird Day, our team takes the time to understand each child’s goals before recommending any supports.

When to Consult a Physical Therapist

Home strategies are a wonderful starting point, and many families see real improvement with simple adjustments. Still, some children need a closer look from a professional. Consider reaching out to a physical therapist if your child:

• Frequently slouches or slides out of chairs
• Mentions discomfort while sitting
• Has trouble focusing during seated tasks
• Struggles with balance or core strength
• Has sensory needs that affect posture
• Seems tired during meals or tabletop activities

A physical therapist can evaluate your child’s posture, core strength, sensory needs, and motor development, then recommend seating supports tailored to your child. Our team at Blue Bird Day specializes in exactly this kind of individualized, family-centered care.

If any of these signs sound familiar, your next step is simple: reach out to your child’s physical therapy team to talk through what you’re seeing. Together, you can find the right path forward.

We offer a variety of adaptive seating options, each designed to meet different sensory and postural needs. Here’s a closer look at four that are available for you to use at home and how each one can help your child:

Wobble Cushions
A wobble cushion sits on top of any chair and creates a gentle, unstable surface that engages your child’s core muscles throughout the day. Rather than sitting rigidly still, your child makes small, constant movements that actually help regulate their sensory system and improve focus. Many families find that children who fidget constantly do much better with this kind of active seating.

• Feature: Inflatable disc with a textured, non-slip surface
• Benefit: Encourages active sitting, improves core strength, and supports sensory regulation without distracting others

Therapy Balls
Also called exercise or stability balls, therapy balls are a classic adaptive seating tool used in homes, classrooms, and clinics alike. Sitting on a therapy ball requires ongoing balance adjustments, which keeps the core engaged and can help children with ADHD or sensory needs stay more alert and ready to learn.

• Feature: Large, durable inflatable ball available in multiple sizes
• Benefit: Promotes dynamic movement, activates postural muscles, and supports attention during seated tasks

Bean Bag Chairs
For children who need deep pressure or a calming, cocoon-like space, a bean bag chair can be a wonderful option. The gentle compression it provides may support sensory regulation and help a child feel grounded and secure. Bean bag chairs work especially well for independent reading, quiet time, or winding down after a busy activity.

• Feature: Soft, moldable seating that conforms to the body’s shape
• Benefit: Provides proprioceptive (deep pressure) input, reduces sensory overload, and creates a calming space for self-regulation

Standing Desks
Sometimes the best seat is no seat at all. A standing desk gives children the option to shift their position throughout the day, alternating between sitting and standing as their body needs. This is particularly helpful for children with ADHD or high sensory-seeking needs who struggle to stay in one position for long periods.

• Feature: Height-adjustable desk surface designed for children
• Benefit: Reduces the demand for prolonged sitting, supports movement breaks, and helps children stay alert and engaged

Our team works closely with each family to select the seating option that best matches their child’s unique sensory profile, postural needs, and daily routine. There is no one-size-fits-all answer—and that’s exactly why we take the time to get to know your child first.

Small Supports Make a Big Difference

Adaptive seating isn’t about “fixing” your child’s posture. It’s about supporting their body so they can participate, learn, and thrive. With the right setup, children often feel more comfortable, more confident, and more capable.

Whether you reach for a footrest, a wedge, a lumbar roll, or a trunk support, every small adjustment helps your child spend less energy staying upright and more energy engaging with the world around them. And that’s a win worth celebrating.

If you have questions about adaptive seating for your child, we’re here to help. Reach out to your child’s physical therapist, or connect with the Blue Bird Day team to learn how we support Chicago families every step of the way.

Frequently Asked Questions

How do I know if my child needs adaptive seating?

If your child regularly slides out of their chair, slouches during meals or homework, complains of discomfort, or seems unusually tired after seated activities, their body may be working extra hard just to stay upright. These are common signs that additional postural support could help. A physical therapist can observe your child’s sitting posture and core strength, then recommend supports matched to your child’s unique needs. At Blue Bird Day, we offer individualized evaluations to help families find the right fit.

Will adaptive seating become a crutch my child depends on forever?

This is one of the most common concerns we hear from families, and it’s a completely valid one. Adaptive seating is a support tool, not a permanent solution. For many children, the right seating adaptations reduce fatigue and allow the body to practice better alignment over time. As core strength and postural stability grow, many children need less support. Your child’s therapy team will monitor progress and adjust or phase out supports as your child develops.

Can I use adaptive seating at school, not just at home?

Absolutely. Adaptive seating supports can be used in classrooms, therapy settings, and at home. If your child has an Individualized Education Plan (IEP), seating adaptations may be included as part of their accommodations. We encourage families to share what’s working at home with their school team so everyone is supporting your child in a consistent way.

This information is not a substitute for professional medical advice. Always consult your child’s healthcare provider or therapy team for guidance specific to your child’s needs.

This post was originally published in March 2023 and was rewritten in September 2026 to include updated strategies.

Constipation is one of the most common gastrointestinal challenges for our kids at Blue Bird Day in Chicago and one of the most frustrating for families.

When your child is uncomfortable, withholding stool, or struggling with painful bowel movements, it has a domino affect on mood, appetite, sleep and overall quality of life.

We have years of experience helping children and families control constipation through gentle massage and movement.

Constipation can happen for many reasons: low muscle tone, sensory processing differences, traumatic bathroom experiences, delayed gross motor milestones, or simply a nervous system that needs more support to coordinate bowel movements.

Chicago families need to know that whatever the cause, there are ways to help you nearby.

This guide walks you through the most effective, therapist approved strategies for supporting gastrointestinal (GI) mobility, improving pelvic floor function, and helping your child feel more comfortable.

If you’d like more personalized insight, please contact us today! We’re here to support you every step of the way.

Why Constipation Happens in Children

Constipation isn’t just about dieting, it’s deeply connected to motor development, sensory processing, and pelvic floor coordination. Children may struggle with constipation due to:

• Low muscle tone (common in children with Down syndrome, Autism, or developmental delays)
• Delayed gross motor milestones (core strength and posture affect bowel movements)
• Pelvic floor dysfunction
• Anxiety or fear around toileting
• Withholding behaviors
• Sensory sensitivities
• Changes in routine
• Limited fluid intake
• Low fiber intake

Constipation can also make potty training more difficult, as children may associate the toilet with discomfort or fear.

Supporting GI mobility through exercise, positioning, breathing, and manual techniques can make a meaningful difference.

Abdominal Massage for GI Mobility

Gentle, structured massage can help stimulate the colon and encourage bowel movements.

Before beginning any abdominal massage, it’s important to understand the basic landmarks: The colon runs from hip bone to hip bone and up to the rib cage. These boundaries help guide your hand placement.

Technique 1: The “Right Hip to Left Hip” Path

1. Start at the right hip bone.
2. Apply firm but gentle pressure upward toward the right rib cage.
3. Move across the belly (above the belly button) to the left rib cage.
4. Move downward toward the left hip bone.

You can use:

• Long strokes
• Small circular motions

Important: Too light = ticklish. Too hard = uncomfortable. Aim for “firm but friendly.”

Technique 2: The ILU Massage

This technique follows the shape of the letters I L U, which represent the path of the colon.

I:

• Start under the left rib cage
• Move downward to the left hip bone

L:

• Start at the right rib cage
• Move across to the left rib cage
• Move down to the left hip bone

U:

• Start at the right hip bone
• Move up to the right rib cage
• Move across to the left rib cage
• Move down to the left hip bone

This technique is widely used by pediatric therapists to support GI mobility.

Video Demonstration

A helpful demonstration of abdominal massage can be found here: Bowel Massage | Connect PT (Explanation begins around the 2 minute mark.)

Exercises That Support GI Mobility and Core Strength

Movement is one of the most powerful tools for improving digestion. When children move their bodies, they stimulate the muscles that support bowel movements — especially the core, spine, and pelvic floor.

Here are therapist recommended exercises:

1. Squats

Squats help lengthen and contract the pelvic floor, which supports healthy bowel movements.

2. Supine Bridges

Bridges strengthen the glutes and core, improving pelvic stability.

3. Single Leg and Tandem Balance

Balance activities activate deep core muscles and improve postural control.

4. Trunk Rotation

Twisting motions help stimulate the intestines and improve mobility.

These exercises can be incorporated into playtime — think obstacle courses, animal walks, or “bridge tunnels” where your child crawls under your bridge.

Diaphragmatic Breathing for GI Mobility

Breathing plays a surprisingly big role in digestion. When children breathe using their diaphragm (instead of their shoulders), it helps massage the internal organs and relax the pelvic floor — both essential for healthy bowel movements.

How to Teach Diaphragmatic Breathing

• Have your child lie down
• Place a hand or small toy on their belly
• Encourage them to “make the toy rise” as they inhale

Helpful Tools for Breathing Practice

These toys make breathing practice fun and engaging:

• Pinwheels
• Floating Blow Pipe Ball Game
• Siren Whistle

These tools help build breathing endurance and can be used both on and off the toilet to support bearing down and relaxation.

Signs Your Child Is Ready for Potty Training

Constipation and potty training are closely linked. A child who is constipated may resist the toilet, while a child who isn’t developmentally ready may become constipated from withholding.

Here are gross motor and physical signs that your child may be ready:

1. Regular Bowel Movements

Healthy, consistent stool patterns are essential. Refer to the Bristol Stool Chart for guidance on stool consistency.

2. Ability to Squat and Climb

Children who can climb onto surfaces or squat independently have the motor control needed for toileting.

3. Good Balance and Core Stability

Your child should be able to sit comfortably and relaxed on the toilet.

4. Adequate Hip Mobility

Good hip range of motion helps the pelvic floor relax, allowing stool to pass without pain or straining.

Balance, stability, and mobility all work together to support successful potty training.

Why Pelvic Floor Relaxation Matters

The pelvic floor is a group of muscles that must relax for stool to pass comfortably. If these muscles are tight, weak, or uncoordinated, constipation can worsen.

Signs of pelvic floor tension may include:

• Withholding behaviors
• Toe walking
• Difficulty relaxing on the toilet
• Straining or discomfort

Supporting pelvic floor relaxation through breathing, posture, and movement can make a meaningful difference.

When to Seek Professional Support

While these strategies can be incredibly helpful, constipation can sometimes be persistent or complex. If your child is experiencing ongoing discomfort, withholding, or difficulty with bowel movements, it’s important to consult a qualified healthcare professional for individualized guidance.

At Blue Bird Day in Chicago, our multidisciplinary team has extensive experience supporting children with:

• Chronic constipation
• Pelvic floor dysfunction
• Sensory based toileting challenges
• Low muscle tone
• Developmental delays
• Autism
• Down syndrome
• ADHD
• Anxiety around toileting

Our therapists use a combination of occupational therapy, physical therapy, developmental therapy, feeding therapy, and sensory integrated approaches to help children feel more comfortable and confident.

Small Steps Make a Big Difference

Constipation can be stressful for children and parents alike. It affects routines, comfort, and confidence — and it can make potty training feel like an uphill battle. But with patience, consistency, and the right strategies, children can make tremendous progress.

Remember:

• Celebrate small wins
• Keep routines predictable
• Use movement, breathing, and massage
• Support your child’s comfort and confidence
• Reach out for help when needed

Your child’s therapy team is here to support you every step of the way.

This information is for educational purposes only and is not a substitute for professional medical advice. Always consult your child’s healthcare provider with questions or concerns about constipation or bowel health.

Frequently Asked Questions

How can movement and exercise help my child with constipation?

Movement is one of the most natural and effective ways to support healthy digestion in children. When your child moves their body — whether through play, structured exercise, or everyday activity — it helps stimulate the muscles involved in bowel movements, including the core, pelvic floor, and intestines. Simple activities like squats, bridges, and trunk rotations can make a real difference.

Even fun, playful movement like animal walks, obstacle courses, or crawling through “tunnels” counts. Diaphragmatic breathing — where your child breathes deeply into their belly rather than their chest — also helps relax the pelvic floor and supports the body’s natural urge to go.

If your child has low muscle tone or delayed gross motor skills, a physical or occupational therapist can recommend movement activities tailored specifically to their needs and abilities. At Blue Bird Day, we weave these strategies into therapy in ways that feel natural and enjoyable for your child.

Can sensory sensitivities make constipation worse in children with autism or developmental delays?

Yes — and this is something we see often at Blue Bird Day. Children with sensory processing differences may find the toilet loud, cold, or uncomfortable in ways that are hard to communicate. Some children are sensitive to the feeling of sitting on the seat, the sound of flushing, or the sensation of clothing removal.

These discomforts can trigger withholding behaviors, where your child holds in stool to avoid an experience that feels overwhelming. Over time, withholding leads to harder stools and more discomfort — creating a cycle that can be difficult to break.

The good news is that with the right sensory supports, gradual exposure, and a calm, predictable toileting routine, many children make real progress.

Our therapists work closely with families to understand your child’s unique sensory profile and create a toileting plan that feels safe and manageable for them.

How do I know if my child is constipated?

Constipation isn’t always easy to spot. Your child may be constipated if they have fewer than three bowel movements per week, experience pain or straining during a bowel movement, pass hard or pellet-like stools, or frequently hold in stool and resist going to the bathroom. You may also notice bloating, stomach discomfort, or changes in mood and appetite.

The Bristol Stool Chart can be a helpful visual guide for tracking stool consistency over time. If you’re unsure, your child’s healthcare provider or therapy team can help you assess what’s typical for your child and recommend next steps.

This post was originally published in January 2024 and was rewritten in July 2026 to include updated strategies.

Winter can be a real buzzkill for activity, especially when you’re a kid who is literally built to move. When it’s cold and dark at 4:30 pm, and everyone has energy to burn, staying regulated and engaged can feel like a full-time job. But here’s the good news: movement doesn’t have to look like treadmills, drills, or “exercise time.” Movement can look like play, laughter, messy living rooms, and the occasional couch cushion obstacle course.

Research continues to remind us that children, especially autistic children, benefit most from movement when it’s fun, flexible, and family centered. So let’s lean into that! Below are playful, low-stress ways to keep bodies moving, hearts pumping, and spirits up all winter long.

Make It Playful for Everyone

Kids don’t always jump right into group activities, but they do watch. They copy. They join when it feels safe and joyful. That’s why the best movement activities are the ones where everyone plays: parents, siblings, even grandma.

When it’s fun for the whole crew, kids are more likely to engage naturally (and stay engaged longer). Check out these three low to no cost games to test out with your family:

1. Don’t Touch the Lava

Zero cost. Maximum chaos. Total win.

What it works on: Balance, coordination, jumping, planning, problem-solving.

You’ll need:

• Pillows
• Couch cushions
• Placemats or safe household items

How to play:

• Scatter “stepping stones” across the room
• Pick a home base (couch or chair)
• Travel across the room without touching the floor (the lava!)

Level it up:

• RESCUE MODE: Toss toys, stuffies, pictures, or sight words into the lava. Call out what needs rescuing.
• LASERS: Add yarn or string to crawl under or step over for bonus adventure points.

2. Dance, Dance the Night Away

Dancing is a sneaky exercise. It boosts heart health, supports regulation, and magically makes winter evenings go faster.

You’ll need:

• A speaker
• A playlist

How to play:

• Everyone picks 2-3 songs
• Shuffle the playlist
• When your song plays, you’re the leader. Everyone follows your moves.

Level it up:

• DIY DDR (Dance Dance Revolution): Draw arrows (up/down/left/right) on paper and tape them to the floor. Call out directions or hold up arrows and step it out.
• Color YOUTUBE Squares: Tape colored paper on the floor (yellow/blue/red/green) and search YouTube for “tapete de movimiento.” Follow along and let the floor guide the moves.

3. Workout with a Kid Trainer

Flip the script. Let your child be the boss!

You’ll need:

• Blue Bird Day Exercise Visuals (or homemade exercise cards)

How to play:

• Your child chooses the exercises
• They decide how many reps
• You do the workout together
• Flip the card when it’s done

Extra fun:

• Randomizer: Draw exercises from a bowl
• Daily Routine: Velcro visuals to a wall and move them to “DONE” throughout the day

Get Out of the House (Without Freezing)

Chicago has some incredible sensory-friendly indoor spaces where you can move, explore, and reset. No snow boots required!

National Museum of Mexican Art

• Flexible visit length (come and go as needed)
• The NMMA Accessibility for All app with plain-language descriptions and visual schedules
• Private tours by request
• A neighborhood mural scavenger hunt for extra steps

Garfield Park Conservatory

• Indoor gardens = nature without frostbite
• Scavenger hunts add structure and engagement
• Sensory Garden (when open) encourages touch and smell
• Tons of at-home resources if you want to extend the experience

Museum of Contemporary Art Chicago

• Sensory-friendly mornings (dimmed lights, reduced sound)
• Sensory kits available on site
• Quiet spaces for breaks
• Not free but library passes save the day!

For more sensory friendly space in Chicago to enjoy year-round, check out our Sensory Friendly Chicago blog post.

Create a Movement Home

You don’t need a gym. You need an imagination. Turn your small spaces into active spaces and watch kids and adults move more without the need to go to the gym or park. Make sure to check out our Gift Ideas for more ideas inspire movement. Many things under $20.

Easy, low-cost ideas:

• Painter’s Tape Agility Ladder: Tape down the hallway and watch kids hop through every time they pass, without any actual tripping hazards.
• Balloon Pit Tub: Balloons + tub or shower = instant joy!
• Cardboard Box Tunnel: Tape boxes together for crawling adventures (decorating encouraged!)
• Yoga Zen Corner: Try a mat, blanket, and flameless candles for a place to stretch, breathe, and reset.
• Stretch Band Tug-of-War: Build strength by attaching them to an anchor or door hinge in an easy to reach place for a fun game of tug-of-war.

The Blue Bird Day Takeaway

Winter doesn’t have to mean less movement, it just means different movement. When activity is playful, flexible, and shared, kids are more likely to engage, regulate, and build lifelong healthy habits. So clear the floor. Turn up the music. Visit that conservatory. And remember: if it feels like play, you’re doing it right!

 

It’s a common scene: a toddler, just learning to walk, lifts up onto the balls of their feet while moving from the coffee table to the couch. This tiptoe style, known as toe walking, is a normal stage in early growth. For many kids, it’s a short-term habit they grow out of as their balance and coordination get better. But for some, it sticks around and might point to deeper issues with senses or movement skills.

As a parent, you may wonder if your child’s toe walking is just a passing phase or something bigger. This guide will help you learn about how toe walking connects to foot strength and a child’s overall growth. We’ll look at the usual reasons kids walk on their toes, how it ties into sensory processing and motor skills, and share fun, easy activities you can try at home to help build a healthy heel-to-toe walk. We’ll also talk about when it’s a good idea to get advice from a physical therapist.

Understanding Toe Walking in Children

Toe walking, or walking on the balls of the feet without the heels making contact with the ground, is common in children under the age of two. As they gain confidence and stability, most kids naturally transition to a heel-toe pattern by age three. When it continues beyond this point, it is often referred to as idiopathic toe walking, meaning it has no known medical cause.

While often benign, persistent toe walking can lead to challenges down the road. It can cause tightness in the calf muscles and Achilles tendons, affect balance, and lead to an awkward running pattern. Understanding the potential drivers behind this habit is the first step toward providing the right support.

Common Causes and Contributing Factors

Why do some children continue to toe walk when others don’t? The reasons are varied and can involve a mix of physical, sensory, and developmental factors.

• Habit (Idiopathic Toe Walking): For many children, toe walking is simply a habit they developed early on and never outgrew. There’s no underlying medical issue, and they can stand flat-footed when asked.
• Sensory Processing Differences: This is a significant factor, particularly for many neurodiverse children. Some kids have a heightened sensitivity to touch (tactile defensiveness) and dislike the feeling of different textures on their feet, like cold tile or shaggy carpet. Others may be under-responsive (hyposensitive) and toe walk to get more intense sensory feedback through their joints and muscles, a sensation known as proprioceptive input.
• Vestibular System Challenges: The vestibular system, located in the inner ear, governs our sense of balance and spatial awareness. If this system is underdeveloped, a child might toe walk to feel more stable or to alter their center of gravity, making them feel more secure as they move.
• Muscle Tightness or Weakness: A tight Achilles tendon or calf muscles can physically prevent a child’s heel from touching the ground comfortably. Conversely, a weak core or weak muscles in the feet and ankles can make maintaining a flat-footed stance more difficult, leading them to compensate by rising onto their toes.
• Underlying Medical Conditions: In a smaller number of cases, persistent toe walking can be associated with conditions like cerebral palsy, muscular dystrophy, or other neurological issues. This is why it’s essential to consult a healthcare professional if you have concerns.

It’s important to remember that these factors often overlap. A child might start toe walking due to sensory sensitivities and then develop muscle tightness as a result, reinforcing the pattern.

The Link Between Feet, Balance, and Development

Our feet are the foundation of our movement. They are complex structures packed with bones, joints, and nerve endings that constantly send information to the brain about our body’s position in space. When children walk with a proper heel-toe gait, they engage the full structure of the foot.

This action strengthens the intrinsic muscles within the feet, builds stability in the ankles, and provides rich sensory information that supports balance and coordination. Toe walking disrupts this process. It limits the range of motion in the ankle and keeps the muscles in the back of the leg in a constantly shortened state while underusing the muscles in the front. This imbalance can make activities like squatting, jumping, and running more challenging.

By focusing on activities that strengthen the feet and improve balance, you are not just addressing toe walking. You are building a stronger foundation for all future gross motor skills.

Fun At-Home Activities to Strengthen Feet and Balance

The best way to encourage a change in a walking pattern is not to constantly correct your child, which can create frustration. Instead, turn therapy into playtime. These fun, engaging activities help strengthen key muscle groups, improve sensory processing, and promote a flat-footed stance without your child even realizing it.

Here are 5-7 activities you can easily set up at home.

1. Animal Walks

Animal walks are a fantastic way to stretch tight calf muscles and strengthen feet and legs. They are playful and easily adaptable.

• Bear Walk: Have your child walk on all fours with straight arms and legs, keeping their feet flat on the floor. This provides a great calf stretch.
• Crab Walk: Sitting on the floor, your child places their hands and feet flat and lifts their hips. Walking forward and backward in this position strengthens the core, arms, and leg muscles.
• Penguin Walk: Ask your child to walk on their heels with their toes lifted toward the sky. This strengthens the muscles on the front of the shin (tibialis anterior), which are often underused in toe walkers.
• Frog Jumps: Start in a deep squat with heels on the ground (as much as possible) and jump forward, landing back in the squat. This stretches the Achilles tendon and builds explosive power.

2. The Homemade Balance Beam

You don’t need professional equipment to work on balance. Create a “balance beam” with items you already have.

• Get Creative: Use a line of painter’s tape on the floor, a rolled-up yoga mat, a row of pillows, or even a plank of wood laid flat in the backyard.
• The Challenge: Encourage your child to walk along the beam without stepping off. To make it harder, have them walk backward, sideways, or carry a small object like a beanbag. This challenges their vestibular system and requires them to use their entire foot to maintain balance.

3. Picking Up Marbles (or Pom-Poms) with Toes

This activity is excellent for developing the small intrinsic muscles within the foot that are crucial for creating a stable arch.

• Set-Up: Place a handful of marbles, small stones, or colorful pom-poms on the floor next to a small bowl.
• The Game: Have your child sit on a chair and use only their toes to pick up the objects and place them in the bowl. You can make it a race or see who can pick up the most in one minute.

4. Walking on Different Surfaces

If sensory sensitivities are a factor, gradually exposing your child to various textures can help desensitize their feet and make them more comfortable with different sensations.

• Create a Sensory Path: Set up “stations” with different textures. You could use bubble wrap, a fluffy blanket, sandpaper (use a fine grit and ensure it’s secured to a board), grass, sand, or a pan of dry beans or rice.
• Explore and Play: Let your child walk, crawl, or stomp through the different stations. Talk about how each one feels—bumpy, soft, scratchy, or smooth. Turn it into a game of “the floor is lava” where they can only step on the sensory pads.

5. Squatting to Play

Lowering the level of play encourages squatting, a powerful movement that naturally stretches calf muscles and promotes a flat-footed stance.

• Adjust the Environment: Set up activities like puzzles, coloring, or building blocks on the floor or a very low table (like a coffee table).
• Encourage the Squat: When your child goes to play, they will naturally need to squat down to participate. This position provides a sustained stretch to the Achilles tendons and requires them to keep their heels down for balance.

6. Uphill and Downhill Adventures

Walking on inclines is a simple yet highly effective way to work on foot and ankle mechanics.

• Indoor Ramps: If you have a wedge cushion or can safely prop up a sturdy board, create a small ramp indoors for your child to walk up and down.
• Outdoor Hills: Find a gentle grassy hill at a local park. Walking up the hill naturally forces a heel-toe pattern and stretches the calves. Walking down the hill requires core control and strengthens the muscles in the front of the leg as they work to control the descent.

Tips for Neurodiverse Kids

Adapting activities for neurodiverse children, including those with autism or sensory processing disorder, can make them more effective and enjoyable.

• Follow Their Lead: Introduce activities slowly and never force participation. If a child is resistant to a texture or movement, try again another day or modify it.
• Use Visual Schedules: Show them a picture of the activity you plan to do. A visual schedule (e.g., “First Bear Walks, then puzzle”) can reduce anxiety and make transitions smoother.
• Incorporate Special Interests: If your child loves dinosaurs, call the activity “Dino Stomps” instead of frog jumps. If they love trains, the balance beam can be a railroad track.
• Keep it Brief and Positive: Short, frequent sessions are often more effective than one long session. Aim for 5-10 minutes of “playtime” a few times a day. Celebrate effort, not just perfection.

When to Seek Professional Help

While at-home activities can make a significant difference, there are times when professional guidance is necessary. A physical therapist (PT) can provide a comprehensive evaluation, identify the specific drivers of your child’s toe walking, and create a tailored treatment plan.

Consider scheduling an evaluation with a pediatric physical therapist if you notice any of the following:

• Persistence Beyond Age 3: If your child is still toe walking consistently after their third birthday.
• Inability to Stand Flat-Footed: Your child cannot physically get their heels to the ground, even when standing still or squatting.
• Stiffness and Pain: Your child complains of pain in their feet or legs, or you notice significant tightness in their calf muscles.
• Functional Difficulties: Toe walking is impacting their ability to keep up with peers, run, jump, or participate in age-appropriate activities.
• Asymmetry: The toe walking occurs on only one side.
• Regression: Your child previously walked flat-footed but has started toe walking again.

A physical therapist can offer targeted stretching and strengthening exercises, manual therapy to improve muscle length, recommendations for appropriate footwear, and other specialized interventions. They can also help rule out or identify any underlying medical conditions that may require further investigation.

A Foundation for the Future

Supporting your child’s development is a journey of observation, encouragement, and playful intervention. Toe walking, while common, offers a valuable window into your child’s developing motor and sensory systems. By transforming therapeutic exercises into fun, everyday activities, you can strengthen their feet, improve their balance, and build their confidence.

Remember to be patient and consistent. Changing a motor pattern takes time. Celebrate the small victories—the moment their heel touches down during a bear walk or the extra second they balance on the tape line. Every step, no matter how small, is progress on the path to strong, stable, and healthy movement.

“RAWRRR!!!” screamed the children from the gym, I mean, the dinosaur cave.  Dinosaur week is here and we’re having a great time! At Blue Bird Day, each therapist creates an imaginary world full of adventure and knowledge for dinosaur week. Science and exploration provide children an outlet for creative play and learning. Plus, dinosaurs are often children’s favorite animal. They are scary, fascinating, and adventurous, and they provide hours of entertainment. From a therapeutic perspective, dinosaurs give movement and exercise an exciting twist. Physical therapy sessions at Blue Bird Day are even more exciting and adventurous when dinosaurs are involved. 

What does dinosaur week look like during a physical therapy peer-oriented session? To start, dinosaurs provide an opportunity to navigate up and down the stairs using big “dinosaur” steps. This gives each child a chance to perfect their reciprocal/step-over stair navigation. It gives motivation for big steps without fear. Going down the stairs is sometimes intimidating for preschool students, but pretend play games where they have to bring dinosaur eggs downstairs make the task less scary.  

While in the gym, dinosaur games take over the session. This includes dinosaur running activities incorporating huge dinosaur steps, galloping dinosaurs, and crawling dinosaurs. There are even dinosaur songs incorporated into each activity. Dinosaur pretend play games assist with peer interactions and collaboration among peers. It also provides opportunities for heavy work tasks to improve regulation. These heavy work tasks include carrying dinosaur eggs to their nest at the opposite side of the room, building dinosaur caves with large pillows and blankets, and jumping and flying like a dinosaur across the room. 

Sometimes, dinosaur roars are intimidating for other peers. These noises are loud and scary, and an important part of dinosaur pretend play is modulating dinosaur roars to a soft quiet level. Dinosaurs need to learn how to be both loud and quiet. Teaching quiet whisper roars help relieve some of the auditory stress noted during dinosaur week. Another important lesson is teaching the children about the differences between dinosaurs. Some dinosaurs are mean and scary, but other dinosaurs are nice and gentle and eat plants. This is helpful when a child is overwhelmed by dinosaur week. If a child becomes overwhelmed, they can form their own quiet dinosaur nest where other dinosaurs are not allowed to bother them. Along with whisper dinosaur voices, this nest helps relieve any anxiety that may occur during physical therapy dinosaur sessions.  

Dinosaur games and activities provide a great way to incorporate exercise and movement into day-to-day activities. Dinosaur week is a wonderful time full of adventure and fun! Provided below are some dinosaur movement ideas that can be completed during an at-home dinosaur week.

Have fun creating your own dinosaur week by incorporating the following activities:

• Take big dinosaur steps – incorporate dinosaur roars and large steps to assist with a step-over pattern on the stairs.
• Hide weighted balls/objects (dinosaur eggs) across the house and tell your child they need to protect each object. This heavy work will provide regulation for your child.  
• Become a flying dinosaur by having your child lift their arms and legs up while lying on the floor. The “superman” position provides a strengthening activity while also flying like a Pterodactyl. 
• Perform large dinosaur steps on flat ground to imitate a forward walking lunge while using T-rex arms. 
• Create dinosaur dice that incorporate various dinosaurs and their own motor movements, including jump like a dinosaur, crawl like a dinosaur, run like a dinosaur, and climb like a dinosaur.  

What is free play?

Free play can be defined as spontaneous play that stems from a child’s natural curiosity and love of discovery. It’s any kind of unstructured activity that allows them to develop their imagination while exploring objects and the world around them! The benefits of free play when it comes to promoting a child’s overall development are never-ending, but as it relates to the development and fine tuning of gross motor skills – here are a few examples:

• A child exploring a new park may discover how much fun it is to run up and down a hill! This is excellent for developing core stability because the core must activate to stabilize the body while on an angle of a likely uneven, bumpy surface. The lower body muscles will also be challenged, right down to the little muscles of the feet! Running up/down hills promotes development of the vestibular system (balance), while also providing proprioceptive input (awareness of where the body is in space).
• When playing with a car or doll, a child will likely transition through many different positions such as tall kneeling, quadruped (hands and knees), and laying on tummy (bonus points if propped up on elbows!). These different positions all require motor planning, bilateral coordination (using both sides of the body simultaneously to perform a task), and will challenge overall strength.
• Dress-up! Stepping in/out of clothing, pulling a shirt or dress overhead, walking in shoes that are too big, spinning around in a dress or cape – all fantastic ways to challenge coordination and balance! Plus, if your child gets into character, there’s sure to be some running, climbing and jumping too!

Some kiddos may need a little help to get inspired, but it’s easy for parents to facilitate free play! Allow some toys to stay out rather than putting them away in bins and closets. If your child sees the toy, they are more likely to play with it. Open ended toys (toys that can be used in a variety of ways), are ideal for promoting free play. Think of things such as building blocks, Magna-Tiles, and doll houses. Even a big cardboard box might become a house or a spaceship! When the weather cooperates, take your little one on outdoor adventures! Make a goal of visiting one or two new parks a month.

There are many advantages of free play both inside and outside the home. Giving your child lots of opportunities for free play is one of the best things that you can do to promote overall development. Structured activities have their time and place of course, but there’s no denying that the benefits of free play can never truly be replicated!

The type of shoe your child wears is important in helping to support proper alignment and protect their feet as they grow and develop. It is also important incase of an emergency where the child needs to be taken outside of school quickly. See below for a list of options recommended by our Physical Therapy Department.  

The American Podiatric Medical Association recommends looking at three aspects of the shoe when searching for the right shoe:  

• Stiff heel cup. You should be able to squeeze the sides of the heel cup without them collapsing.  
• Shoe flexibility. When you bend the shoe up, it should crease where your child’s toes bend.  
• Rigidity in middle of shoes. When twisting shoe side-to-side, it should not easily twist.  

Below are examples of shoes with stiff heel cups, flexible soles, and overall rigidity:  

1. Carter’s

2. Carter’s

3. Stride Rite

4. Cat & Jack

5. New Balance

Shoes with Orthotics

When looking for shoes for orthotics, keep in mind to look for shoes that come in wide sizes, as well as easier ways to secure the shoes, such as Velcro straps and zippers. Below are a few examples of shoes that are can be adjusted to orthotics.

1. BILLY Footwear

2. New Balance

Shoes for Sensory Needs

Some children have sensory needs and prefer to be barefoot. You can first try to find the right socks. You can try seamless socks (Kozieclothes, SmartKnitKIDS, Jefferies Socks) or compression socks so only smooth fabric is touching the skin. If your child still does not tolerate wearing shoes, we recommend a water shoe or a sock shoe with a leather or rubber sole. Shoes should be closed toe and with a closed heel to prevent loss of balance while navigating environment. Below are some examples:

1. Green Sprout Baby

2. Grookz

3. O’Neill Kids Reef Shoes

4. Alex and Nova

If you have additional questions about specific shoes for your child, do not hesitate to reach out to your child’s Physical Therapist!

At Blue Bird Day, our team of Pediatric Physical Therapists incorporate play into their work to promote the development of our clients’ gross motor skills, strength, balance, and endurance. Evidence based practice supports DIR/Floortime as an effective approach to promote development of skills, and incorporating play into our work encourages individual participation and promotes peer interactions. 

Below are different Play Positions for your child to increase their strength and flexibility while having fun! 

 1. Quadruped (All Fours) 

• On hands and knees 
• Ensure knees are directly under hips 
• Hands directly under shoulders 
• Head looking up and forward 
• Back and belly flat 

 2. Prone On Elbows 

• Propped on forearms 
• Elbows directly under shoulders 
• Head supporting itself with ears away from the shoulders 
• Legs together and straight out 

 3. Tall Kneel 

• Knees together or no more than shoulder-width apart 
• Knees directly under hips 
• Trunk upright 

4. Tailor Sit (Criss Cross) 

• Knees flexed and legs tucked in as far as possible 
• Trunk upright 

 5. Side Sit 

• Both legs flexed to the same side 
• Opposite arm can be extended 
• Place an activity or toy on the opposite side of legs for trunk rotation  

 6. Long Sit 

• Both legs straight out in front of body 
• Place an activity or toy on either side of legs for trunk rotation 

 At Blue Bird Day, Eyas Landing, and Merlin Day Academy, our Physical Therapy, Speech Therapy, Occupational Therapy, and Behavior Therapy teams all collaborate to target your child’s unique goals and to help them generalize their skills across multiple environments. If you would like recommendations tailored to your child’s preferences and goals, please reach out to your therapy team and they can provide more information! 

 Watch our caregiver workshop on Meeting Your Kids Where They’re At in Play to learn more strategies on how to promote your child’s play at home!