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.

Photo by Jena Backus on Pexels.com

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 Understood.org.  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.

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!

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!

 

APT Hosts NDT Course

Despite slippery roads and kids home for an unexpected snow day, the course went off without a hitch.  Our course instructors were Gail Ritchie and Brenda Lindsay.

NDT stands for Neuro-developmental treamtment.  From the website:  NDT is a holistic and interdisciplinary clinical practice model informed by current and evolving research that emphasizes individualized therapeutic handling based on movement analysis for habilitation and rehabilitation of individuals with neurological pathophysiology.

Gail Ritchie is an occupational therapist who became an NDTA instructor in 1996.  Her career, spanning 25 years, focuses on supporting children and their families.  Brenda is skilled in a variety of areas including sensory processing disorder, but her focus is to also increase awareness of development and and facilitation of movement through handling in particular for children with autism.

Brenda Lindsay is a physical therapist who was certified in NDT in 1993 and went on to become an instructor in 2010.  Both she and Gail have extensive clinical experience in pediatrics and the autism population.  Both saw a need to bring developmental treatment into autism treatment and created the course to educate therapists about its powerful effects on this particular group of kids.

Members of the OT and PT community gathered over a couple snowy and icy days to take in their knowledge and observe treatment.  All of us came away with a better understanding and appreciation of NDT-based treatment with the kids we serve.  It was a fantastic course.

 

 

 

The Amazing Auditory System

Like the other senses we have discussed in previous weeks, listening is much more than the simple sense it appears to be.  A sound is made, we hear it.  Right?  But listening is so much more than that.  It involves a subtle and and delicate dance between the organs involved in hearing and the brain.  It influences so many other areas of our responses and even our behavior.  Let’s take a brief tour of your auditory system and how it relates to how we perceive the world around us.

Sound is first received by the outer ear and then funneled into the tympanic membrane which uses vibration to transmit the signal.  After passing through a series of other intricately designed structures, the fluid-filled inner ear receives the signal into the cochlea.  The cochlea then separates the sound into frequencies, which travel on its basilar membrane.  Hair cells, in turn, convert the sound into an electrical signal which go on to the auditory nerve, then the brainstem.  Auditory information is then interpreted by multiple areas of the brain and on to the auditory cortex.  Here is where the magic happens, where the brain interprets the sound.  All of this happens in a split second!

This is when listening happens.  Listening is a more complex process in that it involves your child’s whole brain and their whole body.  It connects them to the world outside themselves.  Listening forms the groundwork for skills your child will need throughout their lives.  It helps them to interact with you, first by gazing in your direction when you speak or sing to them.  It helps them to learn to speak, after they have models of you, your family, friends and even radio or Sesame Street.  It is the basis for reading as well as writing and thus is the root of communication.  Listening, like the other senses, does not occur in isolation.  It needs them to give a whole body orientation to the world.

Listening begins in the womb.  The movement of the mother is felt through the fetus’ receptors and at the same time, they are hearing her heartbeat and breath.  The muffled sounds of her voice and other sounds such as music are linked with movements from dancing, vacuuming and laughter.  The sounds are conducted and “felt” through the fetus’ bones and joints.  Rhythmic sounds and movement are comforting to the developing fetus.  As the baby develops and after they are born, sounds are a constant motivator to move, whether that be by lifting their head to look at a sibling or crawling their way into the kitchen to find you as you make the noises of making dinner.

What you may not know is that listening is also instrumental in keeping us aware of space.  Think about the last time you played hide and seek. While your eyes were closed, weren’t you also listening for where the person went, and therefore where in the space they were hiding?  Listening also plays a part in arousal, or how well we are able to match our alertness to the task at hand.  Recent studies are pointing to listening to music as a helpful background to homework.  Listening, because of it’s close proximity to the vestibular system, is also involved in keeping us focused and able to concentrate.  The auditory and vestibular systems sit next to each other physically in the inner ear, but are also sidekicks in the neurophysiology of interpreting sound and interpreting the 3 dimensions of space that you and your child inhabit every day (Frick, 2009).

Listening has long been known to have survival value.  When you hear a sound like a siren, your brain interprets that sound, and you slow down and look in your rear view mirror.  If you heard a sound like the roar of a tiger, you would seek shelter!  Although your awareness of the process is subcortical, meaning you don’t have to actively think about it or do it, your auditory system is constantly scanning the environment for threats or sounds which may signal attention is needed (Frick, 2009).  This could be your baby crying or a child calling for help.  When your brain receives these sounds, your whole body responds.  You actively look for your child.  Your body jumps up from a chair.  The expression on your face may even change, reflecting your concern.  For your child, it could be the call of a teacher or the phone ringing or the sound of their favorite video game. Listening enables the body to react.

What you can do to encourage listening in your child: 

• Dance!  Not only is it a great workout for you, it helps to integrate sound and movement experiences.
• Play hide and seek.  Don’t be afraid to shout hints so they can localize where you are.
• Keep instructions simple at first.  Sometimes visual instructions can help assist verbal instructions (make a map for a treasure hunt).
• Play “telephone” with available props.
• Simon Says.
• Read books out loud and act out the scenes.
• Rock your child while using comforting words when they are upset.
• When you hear a sound, ask them what to do.  For example, “I hear rain, what should we bring so we stay dry?” or “I hear the bus coming.  Are your shoes on?”  or ” I hear your sister.  Where do you think she is?”

Listening, like all the other senses, connects us from within our bodies to the outside world.  It is a source of joy, of connection, of safety and attention.  I hope this serves as a reminder of just how vital the auditory system is, and helps us all appreciate our ears and our brains a little more.

 

 

Listening with the Whole Body:Clinical Concepts and Treatment Guidelines for Therapeutic Listening. Frick, Sheila and Young, Sally.  Vital Links, 2009.

 

 

from an article I wrote for kidsmoveandtalk February 2016

Parenting the Highly Sensitive Child

We have lots of kids who come through our doors that parents describe as “sensitive.”  What does this mean?  The book The Highly Sensitive Child written by Elaine Aron, defines a sensitive child as… (from website)

A highly sensitive child is one of the fifteen to twenty percent of children born with a nervous system that is highly aware and quick to react to everything. This makes them quick to grasp subtle changes, prefer to reflect deeply before acting, and generally behave conscientiously. They are also easily overwhelmed by high levels of stimulation, sudden changes, and the emotional distress of others. Because children are a blend of a number of temperament traits, some HSCs are fairly difficult–active, emotionally intense, demanding, and persistent–while others are calm, turned inward, and almost too easy to raise except when they are expected to join a group of children they do not know. But outspoken and fussy or reserved and obedient, all HSCs are sensitive to their emotional and physical environment.

Sensitive kids require extra attention and modification from their families.  The best route to effective intervention is to accept them where they are and not try to change them.  You can try to change your approach to your child in some different ways, though, to keep things calmer at home and provide some much needed predictability.  Sensitive kids tend to get “triggered” more easily.  They are more emotional and struggle to not become overwhelmed.

For parents needing some peer support, this series of articles on the blog Scary Mommy is really helpful.  Raising a Sensitive Child and My Imperfect Child give perspective on what it’s like to raise a sensitive kid.  Some additional reading is a book that has been recommended by parents is by Ted Zeff called The Highly Sensitive Boy.

In any event, parents often confront a difficult issue with these sensitive (or “emotional” or “difficult” as frequently labeled) is how exactly to discipline them so as not to break their fragile spirits.  From the book and this article in Creative Child magazine, we have some ideas.

Firstly, there are discipline techniques that should definitely be avoided.  Shaming, by way of name calling and “why can’t you get this?” type of correcting are perceived very negatively by your sensitive child and be potentially very detrimental.  Teasing a sensitive child is bound to provoke their intense emotions and likely will not be felt in the playful nature that was intended.  Best to be direct.  Physical discipline is also devastating to sensitive kids and most childhood developmental specialists warn against using it with any kids.  Time outs likely will be perceived as being sent away by sensitive kids and can take an additional emotional toll.  Finally, being too permissive in an attempt to avoid tears or meltdowns is to be avoided as well.  Loving correction is best.

Discipline Techniques That Work Well:

• Be careful of your tone.  Loud does not mean you will be listened to any better, and to a sensitive child can be even more harmful.
• Connect first.  Remind your child you love them and gently tell them what your concerns are.  You don’t want to be perceived as threatening.
• No time outs.  Instead, take your child someplace that will help them to calm down and peacefully explain what went wrong and what should happen next time.
• Consequences should be mild.  Most sensitive kids will adjust their behavior based on their ability to see it displeases you and is not acceptable within the family.  Consequences that make them stand out are shaming and to be avoided.
• Follow up.  Have play time, and use positive language after the discipline has occurred.  This restores connection.

Hope these are useful to you and your family.

Ask any of our OT’s if you have questions or ask about our lending library for resources on sensitive kids.

 

Vision and Your Growing Child

Vision, for most of us, requires no definition.  It’s what we see, it’s what is right there in front of us.  Visual acuity refers to our ability to accurately and sharply see the world around us.  Some of us wear glasses to correct our vision so we can see without blurriness.  Visual acuity is measured by a fixed standard.  However, vision is much more than just what you see.  Amazingly, it’s also how your body and your brain interpret that information. Visual perceptual skills allow us to process and give meaning to what we see using our visual acuity.  Visual perception is broken into a variety of sub-skills that all contribute to acquire visual information and store it for future use.  These skills are often used concurrently. Visual discrimination refers to the ability of your child to recognize the features of objects such as shape, orientation, size and color. A skill that requires visual discrimination is being able to not confuse faces that look alike or words that begin with the same letters. Visual figure ground refers to the ability see an object regardless of the background.  This means that you can recognize your dog from the others at the dog park.  Or the ability to pick a word out of a paragraph. Visual Closure refers to the ability to visually complete an object when given only small visual clues and not the full object.  It means being able to complete a dot to dot drawing or finish a letter once someone starts it. Visual memory is a critical skill for academic success as well.  It refers to the ability to retain visual information over a given period of time.  Kids draw from memory and can replicate an object such as a flower onto a sheet of paper using visual memory. Visual sequential memory is the ability to recall a series of objects, letters, numbers or other symbols.  It’s how you remember your social security number and your phone number. Visual form constancy is the ability to recognize objects as they change size, shape or orientation. Visual spatial skills are essential to understanding directional concepts and to be able to organize your surroundings.  Spatial concepts such as right and left, up and down, back and forth are all the purview of visual spatial skills.  Kids develop coordination, balance, athletic ability and rhythm using visual spatial skills. Visual motor skills (can also referred to as eye hand coordination) are the ability to control movement guided by vision.  Visual motor skills affect your whole body, however, not just hands.  The skills governed by the visual motor system are too vast to name but include tying shoes, hitting a baseball with a bat, putting a puzzle together, kicking a ball that’s been rolled to you and following a hopscotch outline that’s been drawn by chalk on the ground.  Visual motor skills are critical to early academic success in the form of writing, drawing and using scissors. Visual motor and perceptual skills are being used at the same time.  The brain is busy actively interpreting visual information and coordinating responses to it.  It’s complexity is far to extensive to explain here, but a review of what to expect when with your child is as follows: 1 to 2 months:  looks at toys, objects and faces, begins visually following (or “tracking”) them as they move. 2 to 4 months:  holds and looks at rattles and toys, reaches for objects using hands. 6-8 months:   watches as they transfer toys, reach for toys, shake rattle and bang on table 8-10 months:  removes peg from board, bangs blocks together as they gaze in midline in front of their faces 10-12 months:  looks at books, explores toys and utensils 12-18 months:  imitates a scribble, builds a tower 18-24 months:  places pieces in a puzzle 3-4 years:  colors with crayon, copies a circle and a cross, cuts a line with scissors 5-6 years:  cuts more accurately with scissors, prints name and alphabet, can place small key in lock Fine motor development is closely related to visual motor and perceptual development as they are so interdependent.  To help develop your child’s visual skills, consider the following ideas: 1. Encourage scribbling!  Use chalk, crayons, pencils and spray bottles. 2.  Roll out some play doh. Use golf tees to draw into it. 3. Use stencils to play with sidewalk chalk. 4.  Coloring books that start with straight angles then progress to curves.  Don’t worry about staying in the lines too much, just allow fun! 5.  Copying:  let your child watch you copy an object using a pencil or a crayon.  Let them place their hand on top of yours. 6.  Practice following a “road” where the child stays in the line to get from point A to point B. 7.  Use lacing cards, very cute and fun practice for kids! 8.  Practice tapping and catching a balloon. 9.  Use large surfaces such as easels and chalkboards. 10.  Draw shapes with a highlighter for child to trace. 11.  Invest in some cute stencils. 12.  String beads. 13.  Dress up some dolls. 14.  Bean Bag toss! 15.  “Bowling” using old 2-liter soda bottles. 16.  Flashlight tag. The ideas and the fun are endless!  By practicing these developmental activities, you will also be simultaneously working on fine and gross motor skills.  Most of all, just have fun and be engaged with your child.

The Amazing Vestibular System

​​Right now, as you as you are sitting there reading, your vestibular system is hard at work. It enables you to keep your head upright, in midline and to not sway so you are able to keep your eyes in front of you. Your vestibular system, while lesser known than more commonly referred to sensory systems such as vision and hearing, is really the anchor or all sensory awareness.  The vestibular system provides richness to the other systems by supporting them.  Located in your inner ear, and interpreted by the brain, the vestibular system continuously monitors balance and equilibrium. Put simply, it tells your body where it is in space.  Your vestibular system (VS) also helps provide spatial awareness (an organized knowledge of objects in relation to oneself). Let’s take an example to help fully explain this concept.  A five year old little girl is playing in the grass with her friends.  They are taking turns somersaulting down a small hill, giggling all the while.  As she is tumbling, this little girl is also using her vision to check for rocks and trees. She is using her auditory sense to listen for her friends voices so she doesn’t run into them.  She is also using her tactile sense to make sure she avoids any holes or other objects which might hurt to roll over.  Meanwhile, the VS is actively telling her which way is up and which way is down, whether her body is following her head on an accurate forward trajectory and is providing information about where her head is in space.  Her entire nervous system is giving feedback that this is fun and also safe for her, so she is able to experience the joy of the movement.  Kids naturally want to explore in this manner. A healthy vestibular system is the root at the bottom of all sensory exploration and play.  It gives the human body confidence to move in new ways that may seem scary at first.  Vestibular exploration begins in the womb as the baby flip-flops in their mama’s tummy.  As a baby grows, they are of course rocked and bounced, activating the VS every time they are moved.  Once they are able to fully move themselves, they know how different body positions feel and they gain confidence in gravity and their muscles to hold them upright.  Challenging the VS is a natural inclination which is required in order to set the groundwork for all movement.  A healthy VS thus gives a child a sense of safety so that they are able to move with self assurance through the world.  It allows kids to jump through hoops, bounce on trampolines, spin holding their parent’s hands and hang upside down on a tree branch. How to help develop your child’s vestibular skills Make use of your local playground!  Between visits to the grocery store and home, stop at that new playground and have your child give the spinner a try.  If they are scared about trying something, you get on a swing first and show them how much fun you’re having.  They will want to join you.  Going to new playgrounds helps develop new skills and will keep them from getting bored.   play “monkey” by hanging upside down on a small slide, go hands first with a parent at the bottom for safety tilt your head back while spinning for older kids, practice jumping from a swing instead of just stepping off bounce on the ladder crossing The only limit is your imagination! Explore kids yoga!  There are lots of great kid yoga videos available and it’s especially great for those rainy or cold snowy days.  Yoga incorporates many poses which rely on the head being in different positions and it’s a great way to learn balance, a byproduct of a healthy VS.  Yoga, as an added benefit, will also strengthen and provide flexibility to growing muscles. Home activities!  There are lots of ways to promote a healthy VS in your own home. blanket swinging:  you and a partner swing your child in a blanket. stair slide:  use an old cardboard box as a slide down a bank of steps jump on the beds sing songs such as ring around the rosy, or rock back and forth as you sing row your boat.  Wheels on the bus has lots of fun rounds which incorporate movement let them jump off the couch onto cushions your office chair is a super fun spin toy play “popcorn”… as you pop some in the microwave or stovetop, squat down on the ground and pop up into the air, just like the kernels Out and about!  For special outings, choose activities which get your kids outside and away from screens. water parks and amusement parks offer ample opportunities to get those bodies moving! hiking is just walking but spinning down a trail and hanging from a tree branch motivate kids to keep moving aerial parks are super challenging and fun swimming and jumping into water These are just a few ideas to develop a growing vestibular system, but along the way you may discover some new ones of your own.  Feel free to comment and share any ideas you may have!  It is very likely that you may also find that your own aging vestibular system is not as skilled as your child’s when it comes to being able to handle spinning or bouncing.  That’s okay!  Just make sure you provide a good example to your child when it comes to willingness, safety and fun. ​Jeanne From an article published in kidsmoveandtalk.com.

The Power of Play in ADHD

from the University of Vermont website

It’s no surprise that kids with ADHD like to move.  But the University of Vermont has recently done a study that shows kids who exercise prior to school in the mornings were better able to sharpen their focusing skills and help them follow instructions better even later in the day.  What was the plan?  Researchers had parents provide 31 minutes of exercise to their kids in the morning before school.  The exercise included but wasn’t limited to tag, follow the leader and dancing.  There were 5 different activities included over the course of the 31 minutes.  Another group of kids was given seated craft-oriented tasks for 31 minutes.  The kids who exercised demonstrated better attention and lower impulsivity.  What’s remarkable is that the ADHD group had even better outcomes than kids without ADHD.  The next step in the research is to determine whether exercise can stimulate the release of brain chemicals involved in learning.  Pretty cool!

Tracy Stackhouse visits APT!

We were thrilled to welcome Tracy Stackhouse to our Portland clinic on March 6 and 7th.  Tracy spoke about her STEP-SI  model.  The model helps practitioners use clinical reasoning to understand our clients better and plan treatment with a deeper understanding of the impact of sensory processing, relationships, environments, arousal level, predictability and tasks.  Tracy’s work is deeply embedded in the research of Jean Ayres  who pioneered sensory integration as we know it today.  Tracy’s fun and information-packed lectures gave us lots to think about and discuss during that weekend and all our workdays since!

Thank you Tracy for an incredibly informative and dynamic weekend!

 

 

Tracy Murnan Stackhouse, MA, OTR
Tracy, a Colorado native, is president and co-founder of Developmental FX. She is a leading pediatric occupational therapist (OT) involved in clinical treatment, research, mentoring, and training regarding OT intervention for persons with neurodevelopmental disorders, especially Fragile X Syndrome and autism. She received her undergraduate degree in occupational therapy from Colorado State University and a a master’s degree in developmental psychology from the University of Denver. She received her NDT training with Lois Bly. She is SIPT Certified (Sensory Integration and Praxis Test). and was the clinical specialist in sensory integration at The Children’s Hospital in Denver as well as the OT for the Fragile X Research and Treatment Center. Tracy continued her clinical and research work with Dr. Randi Hagerman at the UC Davis M.I.N.D. Institute during its start-up year. Tracy has written several book chapters on sensory integration and neurodevelopmental disorders, and teaches and consults nationally and internationally on sensory integration, Fragile X and related topics. Tracy and her husband have two children.

*from the website for Developmental Fx.