Advanced Pediatric Therapies


Martial Arts helps Woman with Autism

This story of a mom in her thirties who has autism is a truly incredible read! Jen Malia wasn’t diagnosed until after she began martial arts training, but found Tae Kwon Do to be a gift to her .  This martial art, in Korean, “the way of the fist” uses punches and kicks as well as traditional forms and movement patterns.  It is competitive in nature and involves also dancing around on the balls of your feet.

woman punching red heavy bag

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Jen struggled with identifiable problems of autism including balance, coordination, focus, depth perception, executive functioning (got a PhD but had a difficult time prioritizing), social anxiety, obsessive interests, repetitive routines, sensory issues and anxiety.

She says that long distance running along with the practice of tae kwon do helped her with all of these issues.  She spent 5 years earning a black belt and now teaches tae kwon do to kids.  She feels that the combination of these two sports calmed her mind and disrupted “chaotic thoughts.”  She also feels the Asian tradition of repetitive movements and concentrated performance (mindfulness) helped her to learn to make better decisions, focus her attention and organize information.

Any OT can tell you that heavy work will help with all of the above but the article really reinforces how essential these practices were to help her in her journey.  She also received counseling, but credits the martial arts the most with helping her learn new skills.  A great lesson in the importance of using your heavy work and mindful practices to not only help with balance and coordination but also training attention.  Pretty cool!

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Slow Processing Speed: What it is, and What it isn’t

Slow processing speed is a condition in which a child has trouble keeping up with classroom learning.  The speed at which the material is presented is too fast for them to adequately integrate.  A child with slow processing speed may have problems following directions in an accurate and timely manner, be frustrated with classroom assignments/homework and may take an inordinately long time to complete tasks like picking out clothes, cleaning their room or finding a toy.

girl drawing on brown wooden table

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Slow processing speed in and of itself is not a learning disability.  However, it contributes to problems in existing learning disabilities such as auditory processing disorder, ADD and dyslexia.  Slow processing speed can give rise to difficulty initiating tasks/projects, staying focused on the project and also being able to adjust their effort during the project.  For these reasons, it also impacts executive functioning skills.

Kids who are slow processors are often mistaken for not being smart, but it is their ability to take in information at a reasonable pace that is the problem, not their intelligence.  In the classroom, they have difficulty completing multi-step assignments, writing long papers, completing projects within an allotted time, listening and taking notes.  They may become emotionally overwhelmed and anxious with too much going on at once as they are unable to slow down their environment.

If you suspect that your child has slow processing speed, speak to your child’s teacher to see if they have noticed the same problems you have.  You might decide together to have your child tested at the school to see if accommodations can help (such as shorter tests and tests that aren’t timed).

In the meantime, give your child extra time to complete tasks and answer questions.  See if that helps alleviate some frustration.  If you have other children, anticipate that your child with slow processing speed may need an earlier wake up time, earlier warnings for transitions and more time to do chores.  They may need things repeated over and over again, which may be frustrating for you, but it is helpful to them.  The most important thing is that teachers and caregivers are aware of the problem.

Check out this slow processing speed fact sheet on  There is research going on as to why this happens in the brain, but there is no reason why kids with slow processing speed can’t learn, go to college and have successful careers and relationships.

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What are “Accommodations”?

There are lots of kids in schools who have problems paying attention and also problems with learning.  Maybe you have been told your child has a learning disability, or maybe that they have ADD (Attention Deficit Disorder).  There are many names and diagnoses including dyslexia and ADHD.

If you have been told this but don’t know what to do next, first talk to your child’s teacher to see if simple adaptations can work in the classroom.  This may mean moving your child to the front of the classroom so they can pay attention better.  Sometimes it takes a little trial and error to see what works.  If more help is needed, talk to the teacher to find out if you can get an IEP or 504 meeting at your child’s school.  Even if they go to a private school, schedule a meeting with the counselor to get a meeting planned.

close up of woman working

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Accommodations help your child learn what is expected.  Some parents are afraid to “dumb down” the material from the class.  If it’s a purely learning or attention issue, it’s not what they are learning but HOW they are learning that is important.  Accommodations can be anything from seat placement to building in more time to take tests to lighting and more.

If your child already has an IEP or 504 plan, be sure to check in with the teacher at the beginning of the year and periodically after that.  Some teachers are so busy that they may need reminders at times, and your child may be afraid to bring it up.  Remember, accommodations don’t change expectations of what is learned.  They change how they learn or how they can best demonstrate what they already know.

If you don’t know the difference between an IEP and a 504 plan, read this article. An IEP is a plan for how special education will serve your child.  A 504 could possibly be part of the plan.  Both are provided free of charge to students in public schools.  The above article gives a great chart of what each can contribute to your child’s education.

Don’t be afraid to ask questions! A teacher is your best resource and may ask for input from other professionals to devise a plan best suited to your child.

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Getting a Handle on Screens

It’s so hard to manage.  Parents today may not have even had smartphones as kids and now, bam!  They are forced to reckon with those little glowy things that no kid ever wants to put down.

According to the American Heart Association, kids 8-18 spend an average of 7 hours per day in front of a screen.  7 hours!  This includes time in front of phones, laptops, tablets and televisions.  The AHA also recommends that parents actively limit screen time to 2 hours per day for older kids and 1 hour for kids age 2-5.

apple applications apps cell phone

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Why?  There is increasing evidence that kids are spending so much time in front of screens that their obesity rates are increasing, as well as other health indicators such as cardiovascular disease and high cholesterol.  Kids don’t spend nearly as much time outdoors, moving their bodies or in face to face interactions with peers as in generations past.  This is all very worrisome but…how do you do it?

First, start with a media plan for the family.  You can find a link to it provided by the American Academy of Pediatrics here. The newest IOS on Iphone also have screen time monitors on phones that tell you exactly how much screen time each user is racking up.

First of all, you have to model this!  I so often see parents who complain about how their kids are addicted to technology as the parent is texting while they are talking.  You are your child’s first teacher, remember?

Next, find out more about what kinds of apps and games your kids are playing.  Is it all up to your standards?  Educate yourself about ratings and violence.  Some tech companies do not make this easy for parents, but it’s worth the effort.

Do you have times in your family where you do a “digital detox“?  Do you have times where no one is allowed to be on their phones or on screens?

Talk to your kids about screen time.  Set up a family meeting where you can all discuss it together.  This means kids will have opinions which you must listen to, but you may have to override.  In any event, everyone gets a chance to express their opinions but also agree on solutions. Expect some eye rolling from teens, but be honest.  Let them know you will follow the same rules.

Set up an exchange.  So you want a little screen time?  First you have to do your chores, get some exercise or play with your sister.  Make sure the rules are clear.

Most of all parents, remember that sometimes things change (when kids are sick, when YOU are sick etc.).  Try to be flexible and understanding.  These things aren’t going away and we need to try to find a way to live with them in a healthy way.

What helps you set limits on screen time?

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Scientific Validation of Sensory Processing Disorder

Sensory Processing Disorder, aka “SPD”, has a scientific evidence problem.  Science has been slow in providing neuroscientific evidence that the condition actually exists.  For those of you working with and parenting a child with SPD, you know it’s real.  But still, many providers and experts have long suggested that SPD exists only within autism.  Elysa Marco, MD, is trying to change that.

Dr. Marco is a  pediatric neurologist who has spent years researching the phenomenon of SPD.  She recommends the intervention of occupational therapy and other therapeutic treatments in addressing SPD.  She is an advocate for intervention for kids with SPD because “their brains are wired differently.”  Read the article from UCSF about her research and share with families, friends and providers.

Child with SPD playing with his mother in their living room

Photo by Gabriela Hasbun for UCSF article

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We are proud of this APT Mom!


Hello APT families!

We wanted to share this video from CBS News about our own Sandra Sermone, mom of Tony who attends APT.  Tony has a rare autism related condition called ADNP syndrome.  Sandra has been a one woman crusader; spearheading new research with doctors at Mt. Sinai, connecting parents, publishing articles, and creating a website about the disease.  Watch the video and be inspired by her hard work:

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What Can you do to help your child to thrive?


Have you ever heard the term “Emotional Intelligence”?  It was a buzzword back in the ’90’s when the book by Daniel Goleman came out.  It continues forward into today on the website/movement Six Seconds.  As a global movement, it focuses on helping people to know themselves, exercise self awareness and self management and build others up in the process.  It is a natural tool for both teaching and parenting.

In a recent post on the website, Six Seconds describes what kids need to be able to thrive, and how you can support them in doing just that.

It basically breaks down three skills that kids need to flourish. The first is “engaging intrinsic motivation.”  In other words, doing something because they want to, not necessarily because you want them to! It’s inner motivation.  The second is “exercising optimism.”  This means the child has a sense of hope for the future.  And the third is “pursuing noble goals.”  This means they experience that it feels good to be part of a larger purpose.

Sounds like a tall order, eh?  Yes, but to help kids get there (and you, for that matter), they suggest a few simple steps for you to be aware of in your daily life with your little ones, on up to your teens.

1. Give kids the space and power to choose what they want.  Okay, within reason.  It means let them try that gymnastics class even if you think they are not coordinated enough.  It means letting them have more control in their lives at home and at school.  This is a building block of well being for all of us:  being able to choose what we think will work for us.

2. Model what it’s like to focus on these well being skills yourself.  What does that look like?  Try new things, follow your passions, get excited about doing something.  Let them see this in you.  For example, you don’t have to yell at the guy who cuts you off in traffic.  And if you do, you can point out that you maybe didn’t have to let that get you upset.  Find ways to take care of yourself.  Remember, they are ALWAYS WATCHING.

3.  Encourage your kids to have down time.  The lives of many kids, even preschoolers, can be very overscheduled.  Reexamine your family time and see if maybe just one activity at a time could be doable.  Model taking your own downtime.  Resist the pressure that can come from others.  Know what works for your family.

Finally, it should be noted that well being begins a downward trend from ages 7-18.  Practitioners of emotional intelligence want you to know that you can help your child develop these skills.  Their research and data appear on their website



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Is Your Child Getting Enough Exercise?

happy kids , jumping

A recent article in the Journal Pediatrics uncovered a growing problem among preschoolers that has already affected elementary and high school age kids.  Researchers studied the amount of active play that preschoolers engaged in during a typical day at a child care programs in Seattle.  The kids averaged 48 minutes per day, despite ongoing recommendations that kids engage in 2 hours per day of activity.  Pooja Tandon, a professor at the University of Washington and a researcher at Seattle Children’s Hospital cites the worrisome statistics.  Childhood obesity has increased to 18% in kids aged 6 to 11 from 7% in 1980.  Preschoolers have been studied less, but habits developed at this age are likely to follow them to elementary school and beyond.  Day care providers who are more in line with the 2 hour recommendations for active play report improved behavior and even improved sleep at nap time.

What can you do?  Talk to your day care center about how much physical activity is part of their daily schedule.  This includes outdoor time even if it’s raining!

For elementary aged kids, the statistics are daunting.

  • 74% of families say that “family time” is spent in front of a television set
  • 52% of parents say technology is getting in the way of physical activity.
  • 58% of parents say their kids get outside less than 3 days a week.
  • 38% of parents say there is not enough time in the day to achieve physical activity standards.
  • 38% of parents say they can’t afford extracurricular activities to improve physical fitness
  • 41% of families get less than 60 minutes of exercise one day per week.
  • 50% of kids are spending a minimum of 3 hours a day in front of a screen.

With so many kids adopting such low expectations regarding physical activity, their chances for developing chronic diseases like diabetes are increasing.

Consider the following:

  • Most parks and recreation programs have scholarships set up for families who can’t afford extracurricular activities.
  • Kids do what they see:  make sure you have an activity program in place, even if it’s just walking the dog after dinner.
  • Play games that are physical like charades, Twister or Wii.
  • Go outside.  Even if it’s raining.  Kids love puddles!
  • Consider using incentives and think outside the box.  Redefine what it means to “play.”

If you need help setting up an activity program with your child, please ask.  We can help figure out ways to work it into your routine.






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Is Your Child at Risk for Depression?


A recent report on NBC News shared that there are more than 300,000 depressed kids in the United States.  This is an overwhelming number for sure, but there is more to the story.  When thinking of depression, most people think sadness and “the blues.”  While this is sometimes true when talking about kids with depression, it can also be true that kids exhibit other signs which are less readily identified as such.  For example,  irritability may be the first sign of both anxiety and depression in younger kids.  Is your toddler throwing a long tantrum?  1-2 % of toddlers aged 2-5 are depressed.  Depression that goes untreated in younger kids can lead to depression in older kids, too.

Of American kids aged 3-17, 15 million will have a diagnosable mental health disorder during a given year.  Of those, only 20% will receive treatment.  That means 1 in 5 have a perhaps hidden mental health disorder but 2/3 will go untreated.  These diagnoses, as related by the Centers for Disease Control, include anxiety, depression, ADHD and unspecified behavior problems.

Of course, your adolescent can be moody.  This is a hallmark of their age.  However, the tendency to develop a major depression or even bipolar disorder doubles from ages 13-18.  And more than half of all mental health disorders begin by age 14.  In teens, the long term statistics indicate that depression, particularly in girls, is getting worse. This is even more of a reason to keep an eye on your child and report to your pediatrician if you are concerned.  Read the article from NBC News, they will be doing a yearlong investigation into the topic and have provided statistics and hopeful treatments.

For now, signs of depression in kids include difficulty planning/organizing, difficulty concentrating, body language that indicates sadness, forgetfulness, easily hurt feelings, isolation from peers, distractability, complaints of feeling sick/not going to school, crying and forgetting assignments.

For adolescents, symptoms include sulking, self deprecating comments, theft, truancy, sexual activity, alcohol or drug use, isolation, defiance, pessimistic ideas and suicidal thoughts.  

If you have questions or concerns, please speak to your OT or health care provider as soon as possible.  There are treatments that can help!


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October is Sensory Awareness Month!

The STAR Institute for Sensory Processing Disorder has launched a campaign for Sensory Processing Disorder (SPD) awareness this month.  SPD tends to get lumped into autism because kids with autism often have sensory processing problems, but not everyone who has SPD has autism.  This distinction is very important in getting SPD recognized as a disorder all on it’s own.  You can help out by talking to your friends, your pediatrician or posting a link on your social media.  It can be hard to explain, but the STAR Institute’s website is very helpful for you to use and a great place to refer others.  Get the word out this month!


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