Advanced Pediatric Therapies


Get Outside!

Every summer, I’m asked to compile a list of outdoor activities for families.  Our service model changes over the summer from weekly visits to intensives.  During that time, we encourage families to get outside to play and to MOVE!  There are so many fun games and activities to choose from.  Here is just a partial list:


For the little ones:

  1.  Crawl around with your mason jar and find some cool bugs and leaves.
  2. Dig in the dirt, use a shovel and get messy!
  3. Play in the sandbox, making sure to have buckets and cups to lift the sand.
  4. Water the plants with heavy buckets of water.
  5. Use an old sprayer to mist the plants or “paint” a brick wall.
  6. Dig up some rocks that you can then paint.
  7. Put some rags in a bucket of water.  Make a chalkboard target on an outside wall.  Throw!!
  8. Climb a tree.
  9. Help Dad wash the car.
  10. Take the dog for a walk, the more pulling the better!
  11. Play tug o’ war.
  12. Go on a nature scavenger hunt.
  13. Jump rope.
  14. Stack rocks and make a sculpture garden.
  15. Make a mud pie.
  16. Run through the sprinkler, then spin through the sprinkler, then jump through the sprinkler, get creative!
  17. Blow bubbles outside and watch them fly away.


For older kids:

  1. Set up a zip line in the back yard.
  2. A slack line is also great for older kids.
  3. Ride your bike around the neighborhood, try to balance on a chalkboard line in the street.
  4. Go for a swim.
  5. Power wash the back deck. Take some before and after photos.
  6. Hang wet clothes outside on the line.  Or hang artwork, or photos. Host an art show.
  7. Go skateboarding or scootering around the neighborhood.
  8. Play bocce ball in the yard with friends.
  9. Play hopscotch or foursquare in the driveway.
  10. Bring fresh flowers or veggies to a friend.
  11. Deliver newspapers.
  12. With supervision, climb a ladder and wipe some windows.
  13. Play some kickball!  Or volleyball!  Or tennis!
  14. Set up a tent (by themselves) and sleep in it in the backyard.
  15. Do a potato sack race.

Give us some of your own ideas!


Update:  If you have younger kids, check out these cool articles from PBS Kids on Sneaking in Learning over the summer and Best Free Apps to get kids outside.

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OT Favorites you can DIY!

We often get requests from families for equipment that we use in the clinic.  When we refer them to equipment suppliers, they are often unable to afford the high price tag.  Here are some items we often use in the clinic that you can make at home (disclaimer: these have not been made by the therapists here, these are moms who are handy and want to share how they fabricated their own equipment).



This swing was fabricated by a mom who has a blog about her child with autism.  It looks pretty simple to make.  Let us know if you give it a try!  Find the link here.


Sensory hack for kids: how to make a DIY no sew crash mat using items from around the house from And Next Comes L

This mom explains how to make your own crash pad like we have in our gym.  I love her ideas for getting the kids involved.  Find the link here.



How about this cool body sock?  We have a couple here but if you have seen them, they are a fun way to incorporate heavy work into playtime.  This mom shows you how to turn a piece of lycra into your child’s very own body sock!  Fun!  Find the link here.



This mom made a pressure vest for her daughter.  If your therapist has recommended a pressure vest at any time, this may work for you.  We would like you to talk to your therapist before you make one so you know prescriptively exactly what your child would benefit from.  But if you can make it yourself, that would be great!  Find the link here.



This mom made stretchy resistance bands for her kids to help with heavy work play for her kiddos.  This is something that would be really fun for siblings.  Find the link here.



This mom used polyfil to make a weighted blanket.  There are lots of links out there for making your own weighted blankets.  Etsy sells some too.  This seems like it would be good because of the individual pillows holding it all together.  Find the link here.



So many of our kids have trouble quieting their bodies to go to sleep at night.  Sometimes  a super stretchy sheet can help.  This mom made one using stretchy material.  Seems pretty easy!  Find the link here.

If you have made something you would like to share, please do so below in the comments section or share with your OT.  Also if you try any of these, let us know!



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Advocate for Recess!


I remember being in school and the teacher calling this out to us in the lunchroom or class.  It meant (hooray!) it was time to get outside and get all our wiggles out.  Recess means a break from having to sit in one place, use our brains intensely and not having to listen closely to a teacher.  It meant fun, movement and a sort of freedom from the monotony of the school day.  What we didn’t know at the time was that our brains and bodies needed a reset button.  Recess was not a reward, but rather a reserved time just like art, math or lunch.  In our current test-driven educational environment, not only is recess in jeopardy, but it’s value has been called into question.  Recess is not a privilege for kids who are well behaved or get good grades.  Research has shown it to be essential to your child’s development.

Recess in recent years has been limited and even cancelled.  Schools are feeling stress to improve kids’ grades and test scores and the more time spent in the classroom, in their opinion, the better.  Leading educators have been calling this into question more and more in recent years, citing many studies that say that by doing so, we are putting the health of kids at risk.

Research has yet to prove that removing recess with raise test scores, but the following benefits have been proven for kids.  Kids who have recess:

  • Are less fidgety and more on task
  • Have improved memory and more focused attention
  • Develop more brain connections
  • Learn negotiation skills
  • Exercise leadership, teach games, take turns, and learn to resolve conflicts

The American Academy of Pediatrics put out a policy statement in 2013 advocating for the “Crucial Role of Recess” in the development of children.  It is required reading for parents and educators alike.  The paper discusses the cognitive, physical and social benefits of recess in great detail.  In addition, it states that the removal of recess should NEVER be used as punishment.

What can you as a parent do?  The excellent website Peaceful Playgrounds provides handouts, guides and presentations which are easy to download and offer lots of other resources too.  Together, we can take back recess!


from an article I wrote for
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Chore Ideas for the Summer


Ah summer!  Kids get to revel in their school free days.  They sleep late and play all day (depending on their age…your older kids may be more sedentary).  But kids should also be responsible for helping out around the house as well.  Developmentally, kids of different ages should be given appropriate tasks.  In previous posts, we’ve discussed the benefits of “heavy work” in growing a healthy body in terms of neuromuscular development.  Here’s an age by age guide to help you assign tasks that are doubly beneficial:  Both for your family and for the emotional/physical growth of your child.  For each age group, they can also do all earlier age group chores.

Ages two to three:

  • Make your bed with heavy blankets
  • Pick up and put away clothes
  • Collect dirty clothes and bring them to the laundry room.  (Can use a bag and drag them)
  • Wipe cabinets/tables/baseboards.

*Note to parents:  Please remember that your toddler, preschooler or school age child will not be doing these chores the way you do them (sometimes not even high schoolers!).  They will not be perfect. Don’t allow that to stop you.  It will always be easier to do it yourself.  But by allowing them to do these things themselves, you are showing them how to contribute, how to be part of a team and nurturing skills which will make them more independent in the future.

Ages four to five:

  • Put dirty dishes in dishwasher
  • Vaccuum or dust buster small carpets moving up to larger ones, then furniture cushions etc.
  • Roll out recycling bin and trash bin
  • Set and clear table
  • Roll out dough
  • Weeding the garden
  • Water plants inside and out
  • Carry their own books to the library

Ages six to eight:

  •  Meal prep assistance
  • Wipe down bathroom counters and tub
  • Sweep
  • Hang laundry on the line with clothespins
  • Rake leaves

Ages nine to eleven:

  • Fully clean tub and shower
  • Plan and make a simple meal
  • Clean out frig and freezer, wipe down and replace
  • Wash, dry and fold clothes
  • Clean toilets

Ages twelve and up:

  • Mow the lawn (older kids can ask neighbors to do theirs if they’d like to earn extra money)
  • Fully clean the bathroom
  • Shovel snow
  • Iron clothes
  • Vaccuum all floors, mop all floors
  • Straighten and organize closets

There are all kinds of chore charts and ways to keep track with a simple internet search.  Playtime is incredibly important, but so is being part of a family who all do things to help out.  Let us know if there are other chore ideas you have, the list is endless!


From my article in
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The Amazing Vestibular System

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Hello from the APT book club!

apt photoWe recently met at Tamar’s lovely home to discuss “The Whole Brain Child” by Dan Siegel and Tina Payne Bryson.

The Whole Brain Child provides 12 strategies to “nurture” the child’s mind as they grow and mature.  It’s an extremely user-friendly book that makes the neurology easy to understand and the strategies easy to implement.  We have been using some in the clinic (and with our own kids!) since reading the book, many of us for the 2nd time.  We have been using the Wheel of Awareness, “What would you do?” questions, engage don’t enrage and S.I.F.T. most specifically.  Feel free to ask about the book or borrow one of our copies.  We’re here for you!

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Sensory Processing 101: What does it mean?

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Clothing for Sensory Kids!

A parent shared the link for this clothing line called “Independence Day” for her son with autism.  Getting dressed with all the belts, snaps etc. was causing her to set her alarm for an hour earlier just to help him get ready for school.  In addition, the fasteners were irritating to him.  She discovered this line of clothes for young adults which are fashionable, comfortable and you can even purchase a GPS tracker for kids who are at risk for wandering.  The line includes t-shirts, dresses, tunics, leggings and cargo pants.

If you are looking for other sensory friendly clothing for other ages, check out this blog post on Friendship Circle.  These include soft clothes, swimwear, shoes and easy to put on socks.  Check it out!  Please speak to your occupational therapist before ordering any specialized clothing.  We can help you figure out if pressure garments or compression vests are right for your child.


from the Independence Day website

from the Independence Day website





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Do You Have a “Picky Eater”?

Recently, the New York Times blog Motherlode did a series on picky eaters.  The term “picky eaters” is somewhat tricky; you don’t want to pigeon hole your child into a role by calling them something in front of them.  And by the way, most kids are picky eaters.  However, on the website, they tried some new and inventive ways to get kids to eat new things.  They set family goals (meeting together to come up with them, not just parents) and they set family-friendly, non-blaming rules.  For the full article, go here.  Below is a brief synopsis of what they did specifically that worked to help families eat a better variety of foods and make it so there was only one meal being prepared.  (Keep in mind some of our kids have genuine food sensitivities, allergies and triggers that this plan will not address.  Please work with your OT if this applies to you).

photo from WebMD "Quick Tips to Feed a Picky Eater."photo from WebMD “Quick Tips to Feed a Picky Eater.”

Create a mission statement together. What do you hope to achieve together by the end of the six weeks?

Make a few “mealtime rules” for everyone. See below.

Cook one meal together this week. Based on your family’s preferences.

Plant a small herb garden Put a few plants in the windowsill or backyard to harvest from later.

Try one new food Taste something that you’ve never had before and write a quick sentence of what you thought of it to share next week.

If you have a picky eater in the family, know that it can’t change unless you try, and better yet, try together. Create your own “picky eater project” and let us know what works!

Here are the “rules”that the Motherlode readers made:

10 Rules of Picky-free Parenting:

1. As parents, we will be good role models. We will only ask the kids to eat foods that we are willing to eat ourselves.

2. As parents, we will decide what foods are offered, when, and where. As kids, we will decide of the food that is offered, what we will eat and how much.

3. We will value the process of learning to be more adventurous eaters. We will be willing to try new foods, even if it is just a tiny bite.

4. We do not have to clean our plates. We will listen to our bodies and let hunger be our guide.

5. We will not offer food rewards. In other words, we do not have to ‘eat our vegetables’ in order to get dessert. We will not reward good behavior with sweets and ‘treats’.

6. Mealtimes are a family affair. As often as we can, we will shop, cook, and eat together.

7. We are one family, and we will eat one meal. We will not make separate meals. But we will be sure to include at least one thing each family member likes at each meal.

8. We will learn together about food, nutrition, farming, and cooking.

9. We will have fun, play, and experiment with new foods.

10. We will be consistent in following these rules, but not rigid.

For more in the series, including “Nudge Don’t Push,” “Peer Pressure Helps Picky Eaters Try New Foods,” “12 Ideas to Take Back the Dinner Table,”  and “This Kind of Picky Eater is made, not born,” go to the website here.  All the articles are under “The Picky Eater Project.”

Please see a follow up post on ideas for what to pack for lunch now that the kids are back in school!

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Making a Balanced Lunch for your Child

This post was written by Caroline Kaufman, MS, RDN on “Kitchen Explorers”; part of the PBS Kids website.  You can find the article here

We often field questions from parents who are worried that their kids are not eating a balanced diet.  It’s important to try and keep calm.  We can help you when sensory and/or oral motor issues are interfering with your child’s diet.  But these are some common sense suggestions to help make a lunch your child will eat.  Remember that if your child isn’t getting the proper nutrition during the day (either at breakfast or lunch), you may have a meltdown on your hands when they get home from school.  Also, one of the most regulating things your child can do during their school day is sip water from a water bottle.  In any event, get your child involved!  

Does making school lunch stress you out? Of course it does! You have to pack a balanced, edible meal five days a week for a child who hates sweet potatoes one week, and adores them the next. But just because it can be stressful doesn’t mean it has to be. With these five simple strategies that range from planning in advance to cutting yourself some (much needed) slack, you’ll be able to banish school lunch burnout.

1. Get Preppy
If you do little bits of prep throughout the week, you’ll be ready to assemble lunch in no time. For example, when you buy a bag of baby carrots, have your kids divide them into individual portions, so they’re ready to pack when you need them, advises Angie Hasemann, MS, RDN, CSP, Weight Management Dietitian, Pediatric Endocrinology at University of Virginia Children’s Hospital. Yes – the kids. Hasemann says she sees “way too many teenagers who still have their parents pack their lunch. From a very young age, kids should be involved in this chore and taught this skill. It will pay off later.” (You can use your knife skills to cube the cheddar cheese, rinse and halve the grapes, and slice those cucumbers.)

2. Don’t Overthink It
To pack a balanced lunch, just pick something from each of the five food groups. “Adults often forget that kids don’t require their food to ‘go together’ like adults do. They’re more likely to be fine with (and enjoy) random ensembles,” says Hasemann.

Here are some sample foods you can mix and match from the different groups:

  • Grains (1-2 servings): wheat tortillas, whole grain noodles, wheat bread, whole grain pretzels, and popcorn
  • Vegetables (1 serving): baby carrots, edamame, avocado, cucumbers, pickle spears, and roasted sweet potato
  • Fruit (1 serving): apples, grapes, strawberries, clementines, watermelon, kiwi, and applesauce
  • Dairy (1 serving): milk, part-skim cheese stick, yogurt, cottage cheese, and cream cheese
  • Protein (1 serving): turkey, grilled chicken, nut or seed butter, eggs, hummus, and veggie burgers

3. Give Leftovers a Second Chance
There’s nothing easier or more cost effective than re-using something you’ve already made. Meghan Girard, mother of three (ages 4, 2 ½ and 1), makes a double batch of macaroni and cheese for dinner, reheats leftovers the next morning with egg whites for added protein, spinach, and a little extra cheese, and packs it in an insulated thermos for her four year old.

Sara Haas, RDN, LDN, chef, and spokesperson for the Academy of Nutrition and Dietetics offers these creative ways to reinvent leftovers:

  • Stuff stir-fry into lettuce wraps and pack low-sodium soy sauce for dipping
  • Fold BBQ pork into burritos with low-fat cheese and pre-cut veggies
  • Turn grilled chicken into grilled chicken fingers by cutting it into thin strips and sending along BBQ sauce or honey mustard for dipping

4. Find the Fun
Try to find something you like about packing school lunches. For Girard, it’s all about the pumpkin bread. She loves to bake treats and quick breads with her kids, and when she includes a slice in her son’s lunch, he gets so excited he starts bouncing around the classroom, telling everyone his mom made it.

Maybe the fun is watching your kids pack their own lunches…nothing wrong with that. Set up bins in your refrigerator and pantry, recommends Hasemann, one for each food group. “Think a dairy bin with yogurt, cheese sticks, and individually packaged soy milk; a veggie bin; a fruit bin; a protein bin of small packages of nuts, individually portioned hummus, and lunch meat; and a grain bin of bread and pretzels. The kids can grab one food from each bin and pack their own lunch that way.”

5. Go Easy on Yourself
You don’t need to pack a perfect lunch – ever. Instead, do the best you can. Some days will be better than others. If you skipped a food group, you can serve it for breakfast or dinner, or just call it a day and try again tomorrow. In the bigger picture, your stress level has a greater impact on your child’s well being than a serving of dairy on Tuesday afternoon.

Here are easy lunch ideas to inspire you:

5 Simple Techniques to Get Started with Bento Lunches on Kitchen Explorers
Bento Lunches by Wendolonia.comPin It

Submarine Sandwich by Lisa Storms
Submarine Sandwich by Lisa StormsPin It

Customizable Pizza Kabobs by Mom to Mom Nutrition
Pin It

Caroline Kaufman, MS, RDN, is a freelance writer, blogger, and nutrition counselor with a holistic approach to healthy living. She has an A.B. from Harvard University and an M.S. in Nutrition Communication from Tufts University.

What ideas do YOU have for easy, nutritious lunches?  

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