Advanced Pediatric Therapies


“Halloween Tips to Avoid Meltdowns”

I came across this article and thought it would be great for our kiddos.  Originally published by

by Lori Lite

Halloween Tips to Avoid Meltdowns with Kids! Enjoy these TRICKS to make sure your child’s Halloween experience is a TREAT! You and your children will benefit from these tips and most of them can be applied to children with special needs. Children with Aspergers, Autism, SPD, and general anxiety orders can enjoy Halloween with a few adjustments.

  1. Be flexible! Do not make your definitions of a fun Halloween define your child’s expectation of fun.  It is not necessary for children to have the full blown experience in order for them to have a good time.  If you child wants to answer the door and hand out candy, then let them do that without guilt. If your child wants to sit on the porch and costume watch, then let them. If they just want to go to bed……  Trust me it will not matter when they go to college!
  2. Decide and let children know ahead of time how many pieces of candy they are allowed to eatwhile trick-or-treating and after. Let them keep the wrapper to keep count. When they ask for more…ask them to count how many wrappers they have and let them answer their own question.
  3. Head home before your child becomes tired! Do not wait for the meltdown. Think of similar experience and calculate how long you think your child will last.  Let your child know ahead of time how long you are going out for. Bring a timer if your child responds well to timers. Take breaks and check in with how your child is doing/feeling.
  4. Consider your child’s needs. If they do not do well in a noisy group, schedule a friend to trick-or- treat with and stay away from the crowds. Avoid houses with screaming ghosts and flashing lights. You can even hand pick a few supportive neighbors ahead of time to visit.
  5. Costumes could be an entire essay. Most kids do not want to put a jacket over their costume. Direct your child to a weather appropriate costume and consider long johns under the costume. The younger the child the bigger the comfort issue. If your child has sensory issues make comfort of costume a priority. Try it on ahead of time for comfort and have moleskin cloth available. Bring comfortable shoes or sweater if your child refuses to leave the glass Cinderella slippers at home. Colored sweat pants and sweat shirt with hood make an easy costume. Bright yellow with a pair of sun glasses and you have a sun. Sew strips of fabric, yarn, or ears on a hood and you have a lion or a rainbow…Be creative!
  6. Eat a healthy dinner before leaving the house. 
  7. Go early with young children…before it gets dark.
  8. If your child has dietary restrictions, no problem. Let them collect the candy and sell it to you afterwards. Items with peanuts get 5 cents each. A whole bar is 25 cents.  Assign different values for different types. Kids love this exercise and will spend hours sorting the candy into their value group. Take your child to their favorite store and let them spend their candy money on a treat! You can also carry 2 bags. One for the candy that seems OK upon first inspection and one bag that parent carries for “no go” candy. This can eliminate meltdowns over candy later.
  9. All that candy! Too much candy for one family? No problem. Let your child select a handful and leave the rest at the foot of the bed for the Halloween Fairy! If the fairy likes the candy, she will take it and leave a surprise gift in its place.
  10. Take a break!  Trick or treat for a little loop, then come back home or sit on a bench.  See if more trick or treating is best for your child at that point.

Stress Free Kids founder Lori Lite has created a line of books and CDs designed to help children, teens, and adults decrease stress, anxiety, and anger. Ms. Lite’s books, CDs, and lesson plans are considered a resource for parents, psychologists, therapists, child life specialists, teachers, and yoga instructors. Lori is a certified children’s meditation facilitator and Sears’ Manage My Life parenting expert.


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When Should I Keep My Child Home from OT?

Sometimes it's not a good idea for your child to come into therapy.

Sometimes it’s not a good idea for your child to come into therapy.

It’s that time of year again!   Having a sick child this week, it seemed like a good time to think about when to bring your child to OT.

Your child may love coming to OT, but there are times when it is best to stay home.  Please consider the following:

A mild cold is okay.  A minimally runny nose or sore throat is very common in childhood.  We have tissues and we can manage!

Fever, nausea, vomiting or diarrhea in past 24 hours:  Keep your child at home.  They need their rest.

Coughing that interferes with activities:  A mild cough is fine, but one where the other kids are susceptible to getting sick or where your child is not able to concentrate is not consistent with good therapy.  We want your child to be able to get something out of movement, and if they are coughing a lot they won’t be able to do so.

Lack of sleep:  If your child is very sleep deprived, they may not benefit from therapy because of their inability to concentrate and fatigue.   Most of the time, we can work around a tired kid.  Talk to us if you need help with sleep issues.

Pink eye and other highly contagious illnesses:  Please leave your child at home.  We do our best to maintain a clean and healthy clinic, but we can’t control all spreadable germs.

Kids who are clingy, lethargic, complain of pain or who are really “not themselves”:  It’s often best to leave your child at home when your child is behaving this way.

If your child is not well enough for school, they are not well enough for OT:  Please don’t bring kids to OT who have not attended school that day.

Trust your gut:  You know your child best.  Illness is a part of childhood and we will try our hardest to be here for you.  You know when they are able to participate and when they are not.

Remember that even though your child loves OT, it is not always in everyone’s best interest for your child to come in if they are sick.  After all, we want to stay well, too, and be here for your child.

Be well!

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Just a Reminder…


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Help! Recess is a Challenge

Recess is necessary, but can be challenging for some students.

Recess is necessary, but can be challenging for some students.

As we are well in the midst of back-to-school, the topic of recess comes up often.  As OT’s, we are huge proponents of recess primarily as a movement break to help the brain stay active and engaged.  For some kids, particularly those with autism, recess can be problematic.  Excerpted below is a great article from  Some of the ideas may be useful for kids who don’t have autism, but consistently have problems at recess.

Autism and Recess

Most kids just can’t wait for the bell to signal that recess has begun. For many, this is one of the highlights of the school day. For children on the autism spectrum, however, it can be very difficult. Aspects of this period of the day that can wreak havoc on an autistic student are:

  • Lack of structure
  • No expectations
  • Little or no direction or guidance
  • Social interactions dominate
  • Multiple sources of sensory input

Students on the autism spectrum sometimes do better in a structured classroom because:

  • There is a structured routine
  • Expectations are clearly communicated, often with visual aids
  • Teachers and aides offer direction and guidance
  • Academics and instructions dominate
  • There is limited sensory input

Other Considerations

Children with autism may feel overwhelmed, uncomfortable and downright frightened during breaks, lunch and playtime because there is little or no sense of order and control. Sensory overload can be difficult to tolerate and other students may not understand the reactions and behaviors of autistic students. Dealing with recess and autism may seem like a hopeless situation, but each of the problems can be addressed in ways that create loose structure during play activities. Consider the following when developing a plan:

  1. Many kids with autism have to learn how to play
  2. Many want to interact but they just don’t know how
  3. Sensory input can be controlled
  4. A little guidance goes a long way
  5. Many typical students are happy to help
  6. It’s okay for a student to play alone for awhile

Creating a Recess Plan for Autistic Students

The first step in creating a recess plan for a student with autism is to get his parents involved. Recess skills can be included in part of his treatment plan and this requires all members of his treatment team to be on board, including parents. Specific goals can be outlined and interventions put in place.

Creating Structure

The last thing most kids want is to be given directions during recess, but students with autism often like knowing what to expect. Simply offering a choice between swinging and jump rope is a great start. This relatively simple step sets up the child’s expectations. Some kids can benefit from aids like:

  • Picture schedules specifically for recess
  • Stories about recess activities
  • Favorite outdoor toys and activities
  • Social skills and play guidance

Buddy Systems

Many typical students are happy to encourage their autistic classmates to play. Teachers can reward guides with extra credit or “helper certificates”. With guidance, buddies can:

  • Use picture schedules
  • Give verbal and visual cues
  • Serve as a model for appropriate behavior
  • Give reinforcements through praise
  • Offer encouragement

As regular students interact with children on the spectrum, they learn to become comfortable with and appreciate their classmates’ unusual ways of doing things.

Sensory Situations

Sensory overload is uncomfortable and too much input may be overwhelming for some children. Try creating a balance by giving a student with autism a recess schedule that alternates active, loud activities with ones that offer sensory release. Keep in mind that recess is an excellent time for sensory play. Some activity ideas are:

  • Shaking rattles
  • Playing in sandboxes
  • Bouncing on an exercise ball
  • Climbing
  • Playing on slides
  • Running, jumping, spinning, stomping
  • swinging

Recess offers excellent opportunity to help improve muscle tone while promoting good health through exercise.

Schoolyard Bullying

Bullying is a considerable problem across the board, and kids on the spectrum may have difficult defending themselves because of a possible lack of communication and social skills. However, the focus here is on the child with autism, not typical students. In many cases, the student on the spectrum is the aggressor.

In some instances, negative behaviors may be inadvertently rewarded. For example, it is Sally’s turn to be first in line to go outside. James, who has autism, gets in line in front of her and when the teacher guides him back to his place, he drops to the floor, screaming. The teacher in an effort to keep order in the class decides that it isn’t a battle worth fighting and allows James to get in front of the line.

The decision to let James have his way does stop the negative behavior and the class can continue on schedule without incident. However, the decision is counterproductive because he has learned that the negative behavior works in his favor, which increases the likelihood that he will repeat it. In addition, Sally receives a subtle message that James is favored, as does the rest of the class.

Instead, make sure that:

  • The same rules apply to all kids
  • Behavioral expectations are clear
  • Consequences are meaningful, immediate and consistent
  • A crisis management plan is in place

Reccurring aggressive or bullying behaviors an also be dealt with in the child’s treatment plan so it is important that any significant incidents are documented.

Learning How to Play

Perhaps recess and autism is such a challenging pair because kids on the spectrum often have to earn how to play, as other children have to learn how to do math. What better time to learn how to play than during recess?

Let your therapist know if you have found good solutions with your school for recess-related problems.  We’d love to share them with other families!
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Why Can’t My Child Focus?

As your child goes back to school, you may be concerned about his or her ability to pay attention.

As your child goes back to school, you may be concerned about his or her ability to pay attention.

At APT, we see a lot of kids who have a hard time paying attention.  They fidget, they get up, their eyes wander.  There are as many reasons for this as there are kids!  By paying attention yourself, you can help your child focus on the task at hand.

You’ve got to move it, move it…  I apologize in advance for getting that song in your head, but it’s true!  Movement kick starts the brain’s ability to pay attention.  Provided in the proper ways, movement helps a child’s focus.  A great way to start the school year is to walk to school, or if you can’t, park further away and walk.  Try and get some movement going in the morning.  Stay away from the tv.

Talk to your child’s teacher.  Giving them a head’s up on your child is important.  Lots of teachers have great expertise in helping kids to focus with such programs as BrainGym.  Doing wall push ups or dots and squeezes prior to activities which require focus is helpful.  Some teachers set aside long periods for seated work.  Let your child’s teacher know that he or she will need a movement break (which can benefit the whole class!)  If you need suggestions for how to talk to your child’s teacher, ask us!

Read to your child, or do crafts.  When kids see that if they put the time in, they will be rewarded, they are more likely to follow through.  Try your hardest to keep going even when your child wants to give up (squirming, eye-rolling…).  Your commitment to the end result (getting to the ending of the story, a complete craft project) will go a long way to helping your child know the consequences of diligence.

Pay attention to posture and breathing.  When kids are slumped or don’t otherwise have room to expand their breathing muscles, they engage in more shallow breathing.  As such, their bodies are telling them, it’s okay to relax and check out now.  When kids sit up, they are more able to breathe efficiently and thereby pay attention better.  Try it yourself.

Board games.  Those board games that are gathering dust?  Pull them out of your closet and give them a whirl.  A game with a beginning, middle and end is a great way to reward sustained concentration.  You may have more fun than you think you will!  See us for ideas on games your child might like.

Go outside and play.  Tag, hide and seek and catch are great ways to encourage longer periods of focus.  Working in the yard, garden or tool shed with dad are great ways to motivate longer periods of attention.

Rethink technology.  Many of us parents are loathe to allow a child to spend time in front of a screen.  Read this article on the Touch Screen Generation.  It may help you figure it out.  Limiting their time and having them earn screen time are good ideas.

Examine your own reactions.  Try not to let them give up, even when accompanied by whining.  Also, don’t run to help them at the first sign of frustration.  It’s good for your child to be uncomfortable and have to struggle to figure something out.  Now is the time for them to learn those skills.

As always, ask your OT to help you if you have questions or concerns.

Thanks to Pediastaff for some ideas in this post.

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Back to Basics: Why Play Matters

Welcome back to the blog!  We’ve been on vacation-hope you had a great summer!

Time for a reminder of what play is really all about.

Time for a reminder of what play is really all about.

As occupational therapists, we believe that work is the job of childhood.  Okay, not the 9-5, clock in-clock out type drudgery they you may be used to thinking of as work.  Play is the primary occupation of kids and as such, it is where they go to learn, make friends, grow and adapt.

Play helps your child learn about the world around them.  Have you ever gotten your child a present only for them to be more enchanted with the wrapping paper and how it sounds when you crinkle it?  Ever taken them to an awesome playground and all they want to do is play with the rocks?  This type of play demonstrates the innate curiosity kids have for the world around them, and their inner drive to discover how it all works.  By engaging in this type of play, they figure things out like:  how big is it?  how does it feel?  will it interact with me?  what made it?

How cool is that?

Play helps kids learn about themselves and their bodies.  Just by throwing or kicking a ball, kids can learn so much about how their bodies work and how to make themselves or other things move.  They learn how tall or short they are, how strong they are and what they are capable of doing.  Mirrors are a great way for kids to learn about their bodies, but so is movement, which is the focus of most of the play you see at APT.

Play helps kids learn about other kids.  By playing with other kids, your child is able to learn a great deal about socializing, cooperating, compromising, and predicting the behavior of others.  It’s how your kids make friends.  When your child plays with other kids, they learn the value of being part of a team or partnership.  Kids learn even when engaged in parallel play (play alongside another child) and they begin to understand what type of play partner they prefer (quiet, busy, etc.).

Play develops muscles and subsequently coordination, endurance and a host of other physical skills.  By moving their bodies, kids build stronger muscles.  Have you tried doing the monkey bars lately?  That is hard work!  Muscles give joints feedback when they are used and give your child a developing sense of where their body is in space.

Playtime provides relief from boredom, sadness and anxiety.  Research suggests that simply getting your kids outside to play is an effective way to stave off depression and anxiety in today’s high pressure world.  Once the skill to get outside is learned, they are more likely to go there to help themselves when they are feeling a little blue.

As OT’s, it’s our work to help your child most effectively engage in play.  Maybe your child is low tone and has a hard time with physical challenges.  Or maybe they avoid other kids on the playground.  Maybe they get too wild and scare other kids away.  Ask your OT about what we can do to help your child get the most out of playtime.

above image courtesy of New York Times

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