How TMR Tots will Help Your Child

What is TMR Tots?
 

Total Motion Release for Tots and Teens (TMR Tots) is a therapy concept used in physical, occupational and speech therapy to treat both children with developmental delays impacting achievement of motor milestones, and children with neurological &/or orthopedic challenges impacting motor control. Tots was developed for pediatrics but has been found to benefit patients of all ages.  

The primary goal of Tots is to develop symmetrical foundational alignment and postural control needed for balance and skill development. The objectives in treatment are to improve movement, posture, comfort and optimal function in all body systems (respiration, digestion,…) by treating restrictions in mobility.

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The Language of Comfort, The Direction of Ease & Emerging Strengths

In TMR Tots we teach the parent how to listen to the child’s body to identify their strengths using the child's easiest motions. We teach therapeutic positions, releases and play activities that balance their child’s body using only the language of comfort.  As a result, the parent becomes empowered to understand the child’s challenges and learns strategies to improve their function. By incorporating therapeutic activities that are customized and matched to the family’s interests and everyday routines, the child is able to continue to benefit from therapy sessions 24/7 without adding work to an already overfilled schedule. This consistent, comfortable approach has produced accelerated progress and improvement far beyond any previous expectations!  

Restrictions in range of motion create negative consequences in body structure and function. This disrupts the postural foundation needed for optimal development of motor milestones (rolling, sitting, transitions…) and limit a child’s ability to acquire new skills and participate in activities a child enjoys. TMR Tots identifies the child's stumbling blocks and turns them into building blocks!  

Following a comprehensive assessment of parent concerns and observations of a child’s challenges, a 3 step ABC process is utilized for treatment. These ABCs include:  

A. Release - First the stumbling blocks (limitations in mobility) are corrected using a pain free approach which simultaneously utilizes the principles of neuro-plasticity as a child learns to move into directions of ease and comfort.
B. Organize –Feel the new improved alignment with gentle bouncing, touch and sensory information with fun activities help your child’s brain make new and improved connections to reinforce their newly achieved mobility and alignment.  

C. Activities - Finally therapeutic play and positioning activities are customized to meet the child’s and family’s unique needs and daily routines which build on the child’s ability to use the improved control.

Children with developmental delays who have no medical challenges are often held back in their progression to new or symmetrical motor milestones. Most often the child with a delay appears stuck in the same position they were in the womb with subtle restrictions in mobility. Imagine you went on a long car ride sitting in a twist while confined in the back seat with luggage. You get out of the car and work out the kinks or restrictions in mobility . Often the child does not work out these restrictions and stays stuck which can create delays in rolling or crawling symmetrically. These restrictions are easily identified and resolved with TMR to help the child quickly come up to speed with their developmental motor skills.

For children with neurological &/or orthopedic challenges the Advanced TMR Tots Comprehensive Intervention reflects current research on neuro-rehabilitation and methodologies. The TMR Tots assessment identifies emerging strengths and uses principles neuro-plasticity to build on motor control in a step-by-step sequence and to fill in the developmental loopholes. Activities are precisely targeted to build on emerging strengths and challenge a child without struggle or stress.

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Your Child with a Developmental Delay  

Your physician may not have identified a medical diagnosis affecting the nervous system or bones, but your child may be delayed on a checklist of motor milestones.  

What is a delay?

A late start out of the gate where motor milestones or skills are not being achieved on a typical timeline.

A newborn may have torticollis or may struggle with nursing.

An infant may not tolerate tummy time or not be rolling at the typical rate.

A toddler may be butt scooting instead of creeping on hands and knees.

An older toddler may only cruise in one direction or favor play to one side.

A older child may struggle with speech articulation or handwriting.

Many otherwise typically developing children have motor delays associated with stiffness in their soft tissues. This restriction in mobility is thought to be related to residual tension left over from the position in the womb. These blocks in mobility create imbalances in ability to equally move the body in opposite directions (right/left rotation and side bends, bending and extend back). Until the child has these blocks released, they may struggle trying to do skills off balance, and not fully achieve the optimal quality in skill development. (Imagine trying to learn to catch a ball standing more on one foot or trying to learn to write sitting on one buttock!)  

A child with these imbalances can develop compensations, strains and sometimes pain elsewhere in the body. TMR Tots can quickly nip these issues in the bud before they become long term issues with coordination, balance and ability to participate optimally in athletics.

Left untreated, these imbalances can limit optimal achievement of developmental milestones. Using the pain free, no stress no struggle releases these blocks can be quickly corrected bring the child up to speed. TMR Tots activities are designed to build on what a child can do now! Targeted skills minimize the need for trial and error and often a child may quickly catch up with their motor skills.

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Your Child with Neurological &/or Orthopedic Challenges:  

When a child has been diagnosed with medical challenges, there may be exaggerated posturing associated with their diagnosis that reinforce undesired patterns.  Until the child’s body is balanced it is premature to assume that all their movement differences are part of their diagnosis!  Often the same range of motion limitations seen in developmental delays are found and contribute to the child’s challenges achieving motor skills. A significant percentage of their issues may quickly resolve when these imbalances are corrected first. Only then can the therapist determine what percentage of the challenges are related to the medical diagnosis. Once these restrictions are resolved and alignment is achieved the child will receive optimal the benefit from the targeted therapy customized to treat the remaining issues.  

When a child has long standing limitations in mobility (eg: a prolonged NICU stay, hypotonia, orthopedic, or neurological issues impacting acquisition of strength), restrictions may become more established. These blocks in mobility may affect multiple associated areas throughout the body from head to toe. These issues often include problems with digestion, respiration and other negative consequences of challenges with alignment. Tots treats the whole child and issues with all body systems are treated. Progress is tracked as alignment improves and the child may be able to breathe with more ease or digestive issues like reflux or constipation improve!

The TMR Tots assessment identifies emerging strengths and uses principles neuro-plasticity to build on motor control in a step-by-step sequence to fill in the developmental loopholes.

All infants first FEEL and discover they have fingers by touch and visual information

Soon the infant begins to move their hand as they EXPLORE how their fingers can move. Finally, they slowly learn to CONTROL their fingers to hold an object.  

Feeling is the first step missed out by our children with medical issues that limit mobility. a. Supplementation of sensory information is a key part of TMR Tots to reinforce awareness and make the movement become their ability. Tots uses a 3 Step sequence in therapeutic Activities to develop motor control.

1. Feel the motion

2. Explore the motion

3. Use the motion replicate the discovery process seen in the development of any skill in any child or adult.  

As a child is assisted in performing movements to improve range of motion, they are simultaneously being assisted to develop emerging control to perform the same motions more independently. Traditional therapy techniques are overlaid on the TMR motion into directions of ease, emerging control. The positive experience of movement into ease and comfort encourages the child to participate more into expanding control from assisted motion to active motion to independent control.  

Motor control is enhanced using the principles of neuro-plasticity which include: challenge without overwhelming; matching the goal to the unique motivation of the individual (salience); repetition (15,000 repetitions to motor map in the brain); limiting error in trial and error to minimize filtering out confusing information (interference); and use it or lose by matching the participation in the client and family’s daily routine. No special equipment or stressful exercise is needed to do TMR. All strategies are family friendly and developed so that the patient can continue to build on control in their daily routines at home