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NEWSLETTER: The 3rd Annual Shoe Issue

Volume 3, Issue 2

September, 2014

Cindy Surdi, Division Head

Physical and Occupational Therapy Share Foot Fundamentals

School is in full swing and
the PT/OT teams are dedicated to fitness, independence, and of course fashion. Your childs day is jam
packed with activities such
as Kids in the Game, yoga,
our PT/OT movement group
(called Mind, Body, Move)
as well as daily recess within our constantly transforming playground. We are
excited to have all of these
movement offerings built
into the schedule but it has
Dates to Remember:

September 30th: Back to School

Night at CCGS, 6pm.

Inside this issue:


Different Shoes

Shoe Shopping

Helpful Hints

Some fun shoe

Adaptive Devices

Shoelace Tying

and movement activities. If

you send your child in
boots, please send in
sneakers (or an extra pair
of sneakers can stay in
In this Shoe Issue, we are
sharing some general recommendations for purchasing school sneakers with
some specific brands that
have earned PT and OT
thumbs up!

Left: Flat feet

Right: In-toeing

September 20th: Family Picnic

at CCGS, noon-3pm.
September 25th-26th: School

brought many shoe issues

to the forefront of our concerns. Therefore, we are
dedicating this newsletter
For comfort and safety, all
students should be wearing
sneakers or shoes with a
sneaker bottom on a daily
basis. Dress flats are slippery, do not offer support,
or can fall off when running.
Boots (rain and snow) are
great for cold and inclement
weather, but are hot and
clunky for school with stairs

Different Shoes for Different Feet

Unfortunately, there is no single shoe that meets every students needs. The shape of a
childs foot along with the daily
demand of the shoe should
determine the proper sneaker.
For all children, sneakers
should fit snugly and support
the arch of the foot, soles
should be flexible and bend
with the childs movement, and
the child should have the maximum amount of independence
in taking the shoes on and off.
Along with trying on the shoes
for fit, allow your child to try
putting them on and off by
themselves at the store to get
an idea of the level of help
necessary for daily use (see the
ADL portion of newsletter.)
Flat feet: If your child tends to
roll over towards the inside of
his/her foot during walking,
this foot is characterized as
over-pronated or flat feet. If
your child does not use an
orthotic, it is important to find a

shoe with good arch support.

You can test this at the store by
running your hand along the
inside of the shoe to assure
there is a built in arch. If your
child has orthotics an important aspect of shoe buying
is to make sure the inner sole
is removable and there is
enough space for his or her
toes. Also, shoes should be the
proper width to accommodate
for orthotics and be comfortable for your child. We recommend your child be present
during the shoe buying process
and that they are tried on with
the orthotic in place.
Orthotics or not? If you are
concerned that your child requires more support than he or
she is currently receiving from
just a supportive sneaker,
please voice your concerns to
the physical therapy team.
Drug store inserts are rarely
appropriate for our students.
We would be more than happy

to assess and refer your child

to our monthly orthotics clinic
held on site by Childrens
O&P who can recommend or
fabricate a custom orthotic.
Assessment in the orthotics
clinic is complementary with no
obligation to use their services.
In-toeing and narrow feet: It is
important to have a properly
fitting shoe for a narrow foot or
for a gait where your childs
toes point in. However, some
of the brands that have a naturally narrow arch space do not
offer proper arch support. The
same rule should apply when
buying these shoes. Run your
hand along the inside, it should
feel contoured.
Questions? Concerns? Above
are general recommendations
and descriptions. If you have
specific questions, please
contact your physical therapist
for specific recommendations.


NEWSLETTER: The 3rd Annual Shoe Issue

Page 2

Shoe Shopping Help


Children who have difficulty with shoe lace tying

should opt for shoes with
Velcro closures/ elastic
laces. Velcro shoes that
simply flap over are easier
to manipulate then Velcro
straps that need to be fed
through an eyelet. When
shoe shopping, besides
trying for fit, allow the
child to try putting
shoes on with as little
assistance as possible in
the store. This will give
you a realistic idea of the
amount of independence
your child maintains with
the shoes. Shoes
with simple closures are
easier to manipulate and
allow children greater
chances of success and
build their confidence and
independence .

Provide cushion and arch
support. Some models have
Velcro for independence.
Merrell sneakers:
Provide cushion and arch

to maneuver independently.
New Balance:
Runs wide which can be helpful for orthotics. Velcro options. Be sure to select a
model with a flexible sole to
allow for natural stride.

Stride Rite:
Provide cushion and arch
Jumping Jacks Kids:
support. Have Velcro strap
Provide cushion and arch
support. These shoes come in
wide and narrow options.
Champion Sneakers (Target):
CG Sprints Athletic:
Good for in-toeing and narrow
Provide cushion and arch
support. Have Velcro strap &
elastic laces options and feaCG Parade Athletic:
ture a wide toe-box.
Good option for kids wearing
Both are more budget friendly
for a growing child.
Light, flexible sole, available
in child and youth sizes. Single, wide Velcro strap is especially easy for young children


Lack arch support and cushion. High tops are difficult do
get on and off. Snug fit and
extensive lacing creates frustration and struggle for kids
with fine motor difficulties.
Lack arch support and cushion. Boots are bulky and difficult to use during physical
activities, as they limit ankle
range of motion and can
cause tripping and falling.
Toms/slip-ons/ Crocs:
Lack of arch support and
cushion. These shoes do not
provide enough shock absorption for jumping and running
High Tops:
Students with fine motor difficulties have difficulty putting
on and lacing these shoes.
High tops may limit ankle
range of motion and cause
tripping and falling.

Some helpful places to find footwear

Tip Top Shoes: 155 West 72nd Street,
New York, NY 10023 212-787-4960
Harrys Shoes/Kids Store: 2315 Broadway (near 84th Street), New York, NY
10024 212-874-2034
K-Mart : chain, multiple locations
Payless: chain, multiple locations
Target: Chain, multiple locations
Geox: chain, multiple locations
Zappos: Free shipping and returns.
Shoes can be returned 365 days from
the purchase date.
OnlineShoes: Free shipping and returns.
Shoes can be returned 365 days from
the purchase date. Site has an orthotic
friendly shoe filter!

Some Awesome Sneakers at Cooke!

Top Left to Right:
Saucony BLAZE
New Balance
Athletech (Kmart Brand)
Bottom Clockwise from Top Left:
Stride Rite


NEWSLETTER: The 3rd Annual Shoe Issue

Page 3

Helpful Hints
Books About Shoes

Shoes, Shoes, Shoes: A

Delightful Book of Imaginary Footwear for Coloring,
Decorating, and Dreaming by Carol
Chu (Author), Seymour
Chwast (Illustrator)
Fancy yourself a shoe designer? This is the book for you
hundreds of shoes to decorate
along with quotes by shoe

Shoe Dog by Megan McDonald (Author), Katherine Tillotson (Illustrator)

Shoe Dog likes to chew. And
chew and chew. But he doesnt
chew a boring old bone. Not a
squeaky old toy. Not a smelly
old sock. Nope. Shoe Dogs
chewswell, take a guess!

How to Outrun a Crocodile

When Your Shoes Are Untied
(My Life Is a Zoo) by Jess
Chapter book on the travails of
a junior high school student
who lives in a zoo.

Developmentally, first comes removing shoes and socks

before one is able to put them on. You untie laces before you
are able to tie them. It is important to teach and encourage
skills in the appropriate sequence to promote success.
Encourage Independence! Some children may not be able to
put on all items by themselves but they can certainly help
with the process. For socks, place the socks on their toes
and have them pull up the rest. For shoes, you can have
them help with straps. Each child has different abilities. Your child can help and support them to do so!
Make dressing fun! For putting on shoes, pretend the shoe is
a mouth. Teach your child about the tongue of the shoe.
Have them hold the tongue with one hand and the back of
the shoe with the other, say open wide!, aaaahhh and have
the shoe eat their feet.
2-toned Socks: Orienting socks and noticing if they are inside
out can be tricky for your child. We suggest getting 2-toned
socks with colored heels or bottoms to help your child place
them correctly and notice when they are inside out.

Tim donning
his Velcro

Sophia fixing
her socks.

Bi-colored shoelaces - These shoelaces have two colors

(once threaded through the shoe, one side is white, the other
is another color). This helps children tremendously with the
visual-spatial aspect of shoelace tying and also aids right/left
discrimination skills. You can even make your own by tying
two different colored shoelaces together. Keep in mind that
more color contrast is better (i.e white and blue).
Elastic laces These laces promote independence for children who are unable to tie shoes. Once tied, children can
easily slip their foot in/out without sacrificing the stability or
support of a laced shoe.

great example of independence.

Shoehorn A shoehorn may be helpful to use when putting

on shoes to ensure proper positioning of the foot within the
shoe (and prevent stepping on the back of the shoe with the
Longer shoelaces Longer shoelaces are helpful to use
when introducing shoelace tying. This gives children extra
room to master the steps (from a visual-spatial and motor
Practice tying a knot first This involves the first step of
shoelace tying and is easier to learn. Once mastered, begin
to practice all other steps.

I'm Gonna Climb a Mountain

in My Patent Leather
Shoes by Marilyn Singer (Author), Lynne Avril (Illustrator)
A fun read, but dont try this
at home.

Practice on a loose shoe It is easier for children to learn to

tie shoelaces by practicing on a shoe that is not on their foot.
Once this is mastered, begin practice while the child is wearing the shoe.
Bow around the waist - One method of learning to tie a shoelace is to begin by having your child tie a bow around their
waist. You can use a robe, karate uniform or a jump rope! It
is often easier for children to see and feel this task on a
larger scale then transferring the skill to a shoe.
Maxine tying a bow
around her waist.


NEWSLETTER: The 3rd Annual Shoe Issue

1, 2, 3, 4, Shoelace Tyings Not a Chore!!!

Shoelace tying is a difficult
task for all kids, but can be
taught in four easy steps. The
language and steps that follow
are used during occupational
therapy sessions. Consistency
is very important, and the use
of the language and methods
described below will be helpful
when practicing at home.
1. Make an X.
2. Which ones on top
(lace)? (Have the child
pinch the intersection of
the X with one hand to
3. Put it around and through
the tunnel.
4. Pull tight.

Now add the Loopeez device

by following the steps on the
right. After the Loopeez device is in place (with loops
formed) follow the same four
steps listed above.
It is just that simple!!! Remember, practice makes perfect!! For any additional questions, please contact your
childs occupational therapist.

Page 4

To use a Loopeez device:

Begin with the first step of

shoelace tying cross laces,
intertwine, and pull.

Add the Loopeez device by

stringing each lace through
the two holes. Pull the two
laces tight so the Loopeez
device is flat against the

Make loops by pushing the

end of each shoelace (the
plastic tip) back through
each hole. Be sure to keep
the loops as large as possible.

Continue with the steps of

shoelace tying (described
below), but be sure to make
a double knot for stability
(and extra practice).

Timmy tying his


Lucas and Cinelle using Loopeez.

Adaptive Devices
Loopeez This is a simple
adaptive device that is often
used by occupational therapists to stabilize the laces
while the child is learning the
steps of tying shoes.
(see right )

Ocean and Dahlia demonstrating independence

with donning their

LoopersFor children who

are having difficulty keeping
the loops together, Loopers
can be used to help with this
step since their laces are
fitted with velcro.
Loopers training
sneakers and laces.

* Bi-colored laces and Loopeez

can both be found on the Loopeez
website: For a
complementary pair of Loopeez
provided by the Cooke Center,
please email one of our occupational therapists (contact information below).

Any Questions regarding your childs footwear please do not hesitate to contact his or her Physical or Occupational Therapist
Janet Hon, PT, DPT:
Laura Campagna, OTR/L:
Elma Hadrovic, PT, DPT:
Haley Vogel, OTR/L:;
Leigh Connelly, PT, DPT:
Andra Galanter, OTR/L:
Audra Johnson, COTA: