Courtney’s Corner: Learning to Ride a Bike

Soon the weather will start to warm up and Spring will be right around the corner! That means it’s time to start thinking about outdoor activities like riding bikes.

Learning to ride a bike can be challenging for any child, but it might be especially frustrating for children with NF1. Children with NF1 tend to experience developmental delays in some of the key skills necessary for riding a bike such as balance and coordination. While this can make learning to ride a bike difficult, it also makes it all the more important! Not only is riding a bike great exercise, but it also teaches balance and coordination. The more your child practices these skills, the more capable he or she will be of balancing and being coordinated in every day life.

Here are some steps to make learning to ride a bike stress free and fun:

1. Start your child on a tricycle. The skills necessary to ride a trike should emerge between the ages of three and four. If you start your child out young, it will make it easier to learn bike skills in the future.

2. Once your child outgrows the trike, try a low to the ground bike. Most children will feel more comfortable if they can easily reach the ground.

3. Once your child feels ready, focus on teaching him or her how to balance rather than how to move (pedaling). Balance is the primary issue, and pedaling will come with time. To teach balance, skip training wheels and bike down a hill (not too steep!). When your child does both these things, he or she will more readily understand what it feels like to balance on a bike.

If you follow these steps, learning to ride a bike should be a positive experience, but remember, the key may be lots of practice! If your child does not master bike riding on the first attempt, do not give up. Completing multiple short sessions several days in a row may reduce expectations and keep to process fun and stress free for you and your child.

Courtney Dunn, PT, DPT





Message from the Director

It has been another exciting and productive year of advances in research and clinical care at the Washington University Neurofibromatosis (NF) Center. Our clinical and laboratory investigators continue to expand their research initiatives aimed at developing personalized medical approaches for people affected with NF. In addition, we are so grateful for the ongoing partnerships with our families that make these high-risk, high-payoff ventures possible.

We are delighted to share the news that Mrs. Erika Ramirez was promoted to full-time Clinical Nurse Coordinator of the NF Clinical Program at St. Louis Children’s Hospital. Erika previously worked with Drs. Stephanie Morris and David Gutmann as a part-time nurse for our families, but has recently expanded her role to facilitate specialty scheduling and coordinate patient care planning, thus serving as a critical liaison for our families. In addition, Dr. Nicole M. Brossier was promoted to Instructor in the Division of Pediatric Hematology/Oncology. While she is currently completing her postdoctoral fellowship training in my laboratory, she will be taking a leadership role in the management of children with NF-related brain tumors.Lastly, we have recently welcomed Dr. Amy E. Armstrong to our management team. Dr. Armstrong completed her training in Pediatric and Pediatric Hematology/Oncology at Lurie Children’s Hospital (Northwestern University) with Dr. Robert Listernick and Riley Children’s Hospital (Indiana University) with Dr. Wade Clapp. She brings her expertise in NF1 plexiform neurofibroma clinical trials to St. Louis Children’s Hospital.

It has been another year of progress in our understanding of neurofibromatosis, with scientists and clinicians in the Washington University NF Center publishing important new discoveries. These include studies defining how immune system cells control optic glioma growth in mice, developing a mouse model for sleep disturbances in NF1, identifying new genetic markers for brain immune system cells, and characterizing optic gliomas in a pig model of NF1. In addition, one of our Pediatric Neurology residents (Dr. Cristina Gaudioso) completed a large multi-center study of NF2 in children younger than ten years of age. Moreover, we have expanded ongoing collaborations with our colleagues in the Institute for Informatics (Drs. Philip Payne, Randi Foraker, and Aditi Gupta) and the Intellectual Developmental Disabilities Research Center at Washington University (Drs. John Constantino, Susan Maloney, and Kristen Kroll), as well as fortified our international research studies with Professor Helmut Kettenmann at the Max Delbrück Center in Berlin. We also continue to recruit families to participate in clinical research (NF1 Genome Project, NF1 Stem Cell Repository, and Longitudinal NF1 Autism Study), which aim to improve our ability to predict the risk of developing specific medical problems in people with NF1 (precision medicine).

In addition, Washington University NF Center neuroscientists participated in CAMP NEURO, a program designed to educate and expose high school students to medical research. Visitors to the NF Center learned how laboratory studies have advanced our understanding of the health problems affecting children and adults with NF1. Following the tour, one student from the group was inspired to become a neuroscientist, and contacted us about working in one of our laboratories next summer.

David H. Gutmann, MD, PhD, FAAN
Donald O. Schnuck Family Professor
Director, Washington University NF Center
Vice Chair for Research Affairs, Neurology