Originally, TMR Tots was used for children with multiple handicaps, genetic syndromes, hypotonia, cerebral palsy, and acquired brain injuries and was soon found beneficial for children with developmental delays and postural imbalances such as torticollis.
Sensory Challenges, ADHD & ASD
Many children struggle with associated body awareness, mobility, & balance issues. Improvement in alignment can reduce the stress of imbalance. Balancing counter-rotation can improve mobility to help a child find their middle and progress to more mature fluid gait patterns. Tots has been found to be very valuable for children with these challenges & can be adapted to treatment for those that do not tolerate touch.
Patients of Any Age
Many adults need guided manual assistance to perform exercises. Often older patients struggle with poor body awareness, making self-assessment difficult. Patients dealing with arthritis, back pain, joint replacements, or rehabilitation may benefit from the hands-on direction provided by TMR Tots to relieve pain and restore mobility.
The Goals of Tots
The first goal of Tots is achievement of postural symmetry as a foundation for optimal motor control & pulmonary function. Rather than working on a skill first, the TMR Tots assessment identifies the limitation in range or posture that is blocking the child’s ability to develop the skill.
Once blocks in mobility are released with treatment into ease, the child may achieve a skill with less need for facilitation and structured therapy. Children with developmental delays often achieve a skill spontaneously once their mobility is restored. Tots & Teens has been called the prep work for all you do as a therapist creating the balanced foundation upon which to build control and develop skills.
Children with motor control issues are also treated with the scientific methodology of the TMR Tots assessment system. This scientific methodology identifies imbalances in control and transitions to determine where to precisely target application of therapy strategies. This system is used to create a concise care plan to help a child develop motor control using evidence based principles of neuroplasticity precisely targeting their emerging abilities.
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Features of TMR Tots Treatment
1.Range of Motion
Achieved by gentle movement into positions of ease & comfort to promote healing and lengthening of short/ tight structures.
2. Alignment & Postural Control
All exercises focus on improvement of alignment and stimulation of vertical postural control matching the building blocks of typical development.
3. Stimulate Areas of Sensory Deprivation
Unless a child can FEEL a body part, they cannot learn to USE it. Previous lack of range of motion created areas of sensory deprivation. TMR identifies the precise areas that have missed experiences of vision and touch to supplement this important part of development needed as a foundation for motor control.
4. The Discovery Zone
Following releases the improvement the new available range of mobility is precisely measured. This range is an area often never previously accessible to learn to control! It is the fertile ground for neuro-plasticity where traditional therapy facilitation techniques are precisely targeted. In this range or zone the child is able to discover hidden potential for development of control with motor learning strategies.
5. Management of Tone and Abnormal Patterns of Movement
Imbalances in a postural foundation can create stresses which can reinforce undesired patterns and posturing. Frequently children identified with mixed tone who are off balance are in fact tensing up in an effort to find postural stability. Often apparent tone and apparent spasticity are in fact consequences of the stressful posturing in the struggle to maintain an upright posture. Creating a solid postural foundation minimizes these stresses & can assist in the integration of disruptive reflex patterns.
6. Building on Abilities
The philosophy of TMR Tots is that children with challenges learn no differently than the typically developing kid down the block! We all learn by expanding skills building block by building block. Tots focuses on emerging strengths rather than focusing on what has not yet been achieved. The TMR assessment identifies directions of ease which match the activities a child enjoys and can successfully do now. The treatment expands these activities with fun challenges (therapeutic play) to send positive messages to the brain and map patterns of balance, control & movement.
7. Accelerated Progression
Success Without Struggle! Targeted activities are focused on newly accessed postural alignment and mobility. These precise areas of emerging abilities are customized to the individual. Carefully setting up play situations to target emerging control minimizes frustration and the development of inefficient compensatory movement. Structuring targeted play activities with postural support minimizes the error in trial and error to learn loading the brain creates faster achievement of the 15,000 repetitions that current research suggests are needed to motor map control.
8. The Patient Profile - What Is Awesome About You and Your Child?
The first question of every TMR therapy session is “how can I help you today?”
Next you ask the Parent / Caregiver to “tell me about you, your family, your needs, your schedule, what your child enjoys? What motivates them to try to move?” Their concerns are listed on a problem list matched with what specific blocks that limit development in those areas. The therapist then assesses what the child CAN do now! What is emerging success that we can build upon? All the focus is on the bite size building blocks that add up to successful skill acquisition.
9. Caregiver Empowerment
A key component of TMR is parent/caregiver education to help understand a child’s strengths, minimize their struggles, & have the child be the most comfortable and healthy. The home program does not require special equipment or try to make the caregiver a therapist or give them more work in a busy schedule. The program is customized to match what the family already does in play and positioning to make the activities in their daily routine therapeutic.
Activities and positions are selected that complement the objectives of therapy. The therapist offers suggestions that will target the objectives of therapy. The family chooses how they might use these ideas in their daily activities to make their child the most comfortable and engaged in their emerging abilities. Range of motion improves when children are assisted to play in directions of ease . Motor control improves as activities exploring the new ranges insures the child will maximize the number of repetitions needed to learn to control a motion to accelerate progress between therapy sessions
10. Total Motion Is Total Child / Total Family
The 3 components of the International Classification of Function (ICF) Model for treatment focus on your the needs of your family, for function, fun, fitness, friends plus faith, flexibility, and future.
Faith: Looking for hidden potential to develop new available access to build on control.
Flexibility: Serving the individual patient and family meeting their unique concerns and needs in integrating activities into their day
Future: Imbalances in posture and mobility put excessive strains on all systems. Over time misuse , disuse and overuse can set the patient up for future pain and impairment issues. These consequences often are accelerated with growth and immobility
Creating a postural alignment now, minimizes the long term consequences of these stresses later. This foundation helps preserve the child's ability to enjoy optimal participation in the future. Matching the child's strengths and abilities with activities provides opportunities for future participation they may enjoy with peers for a lifetime!
