Advanced Pediatric Therapies


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



Leave a comment »

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.






Leave a comment »

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!


Leave a comment »

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!


Leave a comment »

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.

Leave a comment »

Are Temper Tantrums and Sensory Meltdowns the Same Thing?


Does this look familiar?

I read a great article recently about sensory meltdowns and it was a great reminder to talk to the parents we work with about a dynamic that can very easily be misinterpreted.  So what is a “temper tantrum?”  Most of the time,  temper tantrum is easily recognizable in toddlers and maybe even teenagers!  Your child is not getting their way, or what they want and they pitch a fit, screaming and crying.  They can roll around on the floor, sometimes even hitting their heads against a wall in the extreme.  A temper tantrum is often being characterized by a child being told “no.”

In contrast, a sensory meltdown could better be described as a “release,” or overflow of emotion as a result of being exposed to a sensory input that feels unpleasant or even intolerable.  In the article, the mom describes her 9 year old daughter as holding it together then crying in the car after cheerleading practice became intolerably loud.  Of course, when your child is younger and can’t tell you what the upsetting force was, it gets trickier.  If you see a meltdown coming on, you can ask yourself or your child a few questions, based on your knowledge of them and what sets them off:

  • Is it too bright in here?  Do you need your sunglasses?
  • Do we need to leave?
  • Does your body feel funny?
  • Are you uncomfortable?

Assure them you are there to help.  However, once your child is in a meltdown, they are already experiencing “fight or flight.”  This means that their nervous system has gotten involved, and you are less likely to be able to intervene. At that point, you can:

  • Talk as little as possible.
  • Give them space to breathe, cry, whatever they need to do.  This is what the mom inherently knows to do in the article.
  • Remove them from adverse environment.
  • Plan for next time!  Make a “retreat” in your home:  a quiet space with noise cancelling headphones, quiet music, dim lights and away from anything unpleasant. Maybe some gum, a quiet toy but no screens.


Leave a comment »

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!



Leave a comment »

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
Leave a comment »

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
Leave a comment »

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
Leave a comment »