Advanced Pediatric Therapies

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October is Sensory Awareness Month!

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

 

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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:

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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.

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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!

Jeanne

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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Are Temper Tantrums and Sensory Meltdowns the Same Thing?

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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.

 

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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).

THERAPY SWING:

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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.

CRASH PAD:

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.

BODY SOCK:

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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.

PRESSURE VEST:

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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.

STRETCHY RESISTANCE BANDS:

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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.

WEIGHTED BLANKET:

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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.

STRETCHY SHEET:

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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!

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“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!

Jeanne

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from an article I wrote for kidsmoveandtalk.com.
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Chore Ideas for the Summer

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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!

Jeanne

From my article in kidsmoveandtalk.com
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The Amazing Auditory System

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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
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Parenting the Highly Sensitive Child

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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.

 

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Vision and Your Growing Child

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The Amazing Vestibular System

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