HeartSpacept

11/03/2025

So great to see the growing interest in paediatric pelvic health at the APTA Annual Pediatrics Conference this weekend! I am always excited to present alongside my super smart friend and colleague . Adult pelvic floor-centric practice models overlook developmental, motor, sensory, and emotional factors. Julie and I have been talking about this for 18 years - clinical practice is overdue for change! We teach a trauma sensitive, external, indirect, dynamic systems based approach to paediatric pelvic health that respects the complexity of our maturing neurotypical and neurodiverse clients.
To learn more, join us Nov 13th for a 1-hour FREE webinar in the "Let’s Talk Pelvic Health" series. Or join our hybrid courses live in Guelph Ontario or Montreal Quebec in 2026.

10/31/2025

10/30/2025

Last in this series as we discuss the autonomic nervous system, parasympathetic and sympathetic excess and the symptoms associated with orthostatic intolerance, this study suggests there may be an association between ASD and hypermobility. As we support our autistic clients from an early age, this possible association is something we should add to our clinical thinking as we consider how best to support them.
https://pubmed.ncbi.nlm.nih.gov/40145613/

10/28/2025

Continuing to consider the interconnections between hypermobility, dysautonomia and orthostatic intolerance (=dizziness on standing). This article discusses parasympathetic and sympathetic nervous system function in those with hypermobility/EDS.
Key takeaways:
*The ANS is very active during development which may mask dysautonomia until the late teens/early 20s, corresponding to the development of symptoms
*"Leaky" connective tissue in EDSh may cause an ongoing immune response, leading to parasympathetic excess (PE) which forces a corresponding sympathetic excess (SE)
*Symptoms of dizziness when standing (=orthostatic intolerance), fatigue, exercise intolerance, shortness of breath, palpitations and chest pain present in EDS are often a result of the ANS dysfunction
http://bit.ly/4hpeztp

10/23/2025

Following up on the last article regarding autonomic responses and orthostatic intolerance. It turns out, children with Ehlers-Danlos Syndrome (EDS) or hypermobility spectrum disorder (HSD) are over-represented in pediatric populations with postural orthostatic tachycardia syndrome (POTS). So as we see children with hypermobility in the clinic, we should keep these connections in mind.
Key takeaways:
*Over one fifth of clients with POTS had EDS
*Over one third of clients with POTS had HSD
*Combining these stats, over half of clients with POTS had hypermobility
*Easy bruising, hyperelastic skin and joint dislocation were the only symptoms that happened more frequently in children with hypermobility as compared to those without
https://pubmed.ncbi.nlm.nih.gov/33388686/

10/21/2025

I went on a bit of a hunt a couple of weeks ago, digging into understanding more about autonomic responses and orthostatic tolerance. This 2025 article discussed fainting (=syncope, often vasovagal syncope or postural orthostatic tachycardia syndrome/POTS).
Key takeaways:
*Syncope is characterized as loss of postural tone and transient loss of consciousness.
*Syncope happens in 15-20% of children and 1/3 of these have associated symptoms - dizziness, nausea, light-headedness, abdominal discomfort, brain fog, visual
disturbances, and fatigue
*These symptoms are often related to autonomic dysfunction
This all got me thinking about our clients with hypermobility. More to come.
https://pubmed.ncbi.nlm.nih.gov/40972410/

10/18/2025

My deepest gratitude to the participants of the Creating Connections Handling Intensive. It was an outstanding 4 days of learning. And to for all their organizational support.

10/15/2025

So many clinicians hear from parents and see the difficulties experienced by children with GI issues. This 2025 study analyzed the literature and demonstrated correlations between gastrointestinal symptoms (GIS) and differences in profiles for children with ASD in early to middle childhood.
Key takeaways:
*Autistic children had greater frequency of GIS
*Autistic children presented with a higher number of concurrent GIS
*Most common GIS were constipation, diarrhea, gaseousness/bloating and abdominal pain
*GIS is often misdiagnosed or under-reported in autistic children due to communication and sensory differences
*Children experiencing GIS presented with more sleep issues, somatic complaints, internalizing problems.
https://pubmed.ncbi.nlm.nih.gov/40877047/

10/13/2025

Trunk control has an impact on both upper extremity and lower extremity function in children with CP. This 2025 study is yet another article that suggests we focus our intervention supports on improving trunk control to improve function.
https://dergipark.org.tr/en/pub/medr/article/1585172

10/09/2025

If you follow along here you know that one of my favourite principles is . Join me for this one day, live webinar on a dynamic systems approach to postural control in a school based model. We'll discuss the systems in some detail, note the connections as well as address possibilities for assessment and treatment in children with sensory and motor profiles. Early bird registration is on now. http://bit.ly/3IXam3e

10/06/2025

This was posted as part of a comment on early intervention for children with CP. I would respectfully suggest it applies to all babies and young children.
https://pubmed.ncbi.nlm.nih.gov/40847471/

09/29/2025

This 2025 meta-analysis examined Dual Task Training (DTT) in training balance, gait and gross motor tasks in children with CP. DTT has been studied previously, looking at pairing balance training with an additional cognitive or motor task in this population.
When we look at postural control through the lens of dynamic systems (the 2nd pic is my working clinical model), DTT success shouldn't be a surprise. This intervention is where cognitive resources come into play.
Key study takeaways:
*Improved static postural balance with eyes closed
*Improved walking speed
*Observed improvements with in standing and walk/run/jump domains of GMFM
*Subgroup analysis revealed motor-cognitive DTT is superior to motor single task but no mention was made of dual motor tasks
https://pubmed.ncbi.nlm.nih.gov/40870460/