Advanced Pediatric Therapies


Scientific Validation of Sensory Processing Disorder

Sensory Processing Disorder, aka “SPD”, has a scientific evidence problem.  Science has been slow in providing neuroscientific evidence that the condition actually exists.  For those of you working with and parenting a child with SPD, you know it’s real.  But still, many providers and experts have long suggested that SPD exists only within autism.  Elysa Marco, MD, is trying to change that.

Dr. Marco is a  pediatric neurologist who has spent years researching the phenomenon of SPD.  She recommends the intervention of occupational therapy and other therapeutic treatments in addressing SPD.  She is an advocate for intervention for kids with SPD because “their brains are wired differently.”  Read the article from UCSF about her research and share with families, friends and providers.

Child with SPD playing with his mother in their living room

Photo by Gabriela Hasbun for UCSF article

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We are proud of this APT Mom!


Hello APT families!

We wanted to share this video from CBS News about our own Sandra Sermone, mom of Tony who attends APT.  Tony has a rare autism related condition called ADNP syndrome.  Sandra has been a one woman crusader; spearheading new research with doctors at Mt. Sinai, connecting parents, publishing articles, and creating a website about the disease.  Watch the video and be inspired by her hard work:

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The Benefits of Swimming for your Child

Swimming is a great activity any time of year, but summer seems the best time to introduce your child into a great hobby, sport or adventure in the water.  When we says “swimming,” it doesn’t mean that your child has to be doing the breast stroke, or any stroke at all.  It means your child is immersing him or herself in water and playing!


If you child has been fearful of swimming in the past, consider the environment in which they were scared.  Was it an indoor pool with lots of echoes and noise?  Was it a lake with a slimy bottom?  Was the water too cold?  If so, maybe take them to a warmer pool on a day when it’s less crowded.  For kids who are easily overstimulated, a weekend at a water park may not be the best introduction.  Do your research on the pool where you want your child to take lessons.  Do they have an instructor who is familiar with kids with special needs and/or sensory processing disorder?  Are private lessons available?

On the other hand, some kids are water babies from the start.  They love the water but all kids need to be monitored for safety.  No matter where your child starts, there are a number of benefits to swimming for our kids.

  1.  Calming.  Water provides 30% more pressure to our bodies than living on dry land.  We know that pressure provides calming to our active nervous systems.  You will notice a difference in your child after they do some active swimming, particularly underwater (more pressure).  They are more calm and more organized.
  2. Stimulates vestibular sense.  When you are diving into water, doing flips underwater or doing various strokes, your head is in different positions.  Combined with the deep pressure, these two systems work to achieve better balance and overall body awareness.
  3. Strength.  Because of the pressure in water, there is resistance provided against your body which thereby increases your strength as you work against it. Because being in the water is so much fun, kids barely even notice the additional challenge.
  4. Improves gross motor skills.  Being in water lessens the effects of gravity.  For this reason, it’s easier to stand on one leg or jump or do any activity with more coordination than on dry land.  It builds confidence in kids for whom these things are difficult.
  5. Improves motor planning.  There are so many pool toy and accessory options for kids in a pool or lake setting.  How many ways can your child use a noodle?  Or a kickboard? Finding new uses engages and uses motor planning skills.

Kids should be encouraged to make active use of the pool, and avoid passive activities like the “lazy river” for these benefits to take shape.  (Of course, at the end of a long day, it’s pretty nice!)  And please refer to your local and state laws around use of life jackets for safety.

Now go out and enjoy the water!


For a list of local pools run by Parks and Recreation in Vancouver, please visit this site.


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Happy New Year!


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Use Sensory Strategies to Make Mornings Less Hectic

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Self Regulation 101

 Here is an article I wrote for about self regulation:


Self regulation is the current buzz term in parent and developmental literature.  We’ve all heard of the famous “marshmallow study” where a marshmallow was placed in front of a child by an adult who also told them not to eat it, then left the room.  In the study, the kids who were able to control their impulses (and thereby earn a second treat) were followed up years later and found to have generally done well in life (think: good SAT scores and a lower body mass index).  The marshmallow study, originally done in the early 1960’s by Walter Mischel, has been called into question for it’s methodology, but it is still often quoted and referenced.  Mischel even recently wrote a follow up book about the study.  But the basic principle holds true through years of research: A child who is able to monitor and control their own behavior builds lifelong skills such as persistence in the face of challenge, ability to deal with anxiety and problem solve in an increasingly complicated world.

In a behavioral context,  self regulation refers to the ability to act in a long term context consistent with your deepest values (Psychology Today).  What does this mean for a child who is still developing a moral compass?  Primarily that they value the power of adults and morally want to please them.  It may also mean that they deeply value candy!  In either case, the child shows a resolute decision to forego the immediate pleasure to attain a greater reward.  In an emotional context, self regulation refers to the ability to calm yourself when upset or even keep yourself from getting upset in a the first place when some sort of trigger arises.  Kids do not have the full cognitive ability to self regulate at all times, their brains simply are not developed enough to do so.  Hence, tantrums occur.  Learning self regulation is a lengthy process that occurs throughout development and can still be learned into adulthood.

Developmentally, even newborns turn their heads away from things they perceive as noxious such as, loud noises or bright lights.  By about age 12 to 18 months, children are able to change their behaviors upon request, if not all the time.  They respond to social and verbal cues from their parents such as “blow kisses”. By about age two, if a known caregiver is not present, they are able to transfer these skills with people they don’t know as well.  From age 3 to 11, these skills continue to grow.  Kids are beginning to learn that they need to wait until mom is off the phone until they can receive that snack they want.  Of course, they are still not able to completely resist impulses at this age, as any parent of a young child will attest!

Older kids and adolescents, while better at self regulating than younger children, may still have problems curbing impulses.  As their brains develop, though,  they are better able to know what works for them and what doesn’t (parents also are learning these things about their own children).  For example, a child may decide to go outside and play when they are angry with a sibling simply because they internally know it will distract them from the upsetting incident.  Similarly, an adolescent may use that same intuition to reach out to a friend to help them calm their nerves before a tough test at school.

What might keep a child from being able to comply with requests or calm themselves down?  Many factors as it turns out.  A child who doesn’t want to play with a certain toy is more likely to help put it away.  Other factors such as fatigue or hunger can affect all of us in being able to keep our emotions in check.  Whatever the situation, kids who buy into the request have an easier time complying than those who don’t agree.  For this reason, it’s recommended to give the request a positive spin rather than a negative.  For example, instead of saying, “You can’t have candy for breakfast!’, say, “How about some delicious eggs for breakfast?” It’s always a good idea to help your child see, in as few words as possible, the positive aspects of a given choice.

The following are also great ways to help your child self regulate as they grow from infants to adolescence: (Gillespie, 2006)

  • Observe:  A baby will tell you she’s hungry by fussing or crying.  But an older child is harder to read.  They may come home from school out of sorts.  You may need to help them to regulate themselves by offering a snack or sitting down to talk with them.  You can also help identify their personal triggers such as crowded spaces or noisy areas.
  • Respond:  Be aware of your child’s particular needs.  Do they need some time and space?  Or do they need tighter routines and order? In the above example, a child may need to move their body to help them reorganize themselves after a busy day or a fight with a friend.
  • Provide structure and predictability:  Let your child know if things may change.  Give them an idea of what’s happening that day or week.  Keep a family calendar.
  • Keep it developmentally appropriate:  You can’t expect a toddler to sit quietly in a waiting room for half an hour.  Bring toys or games to keep them occupied.  For older kids, ask them if they need some space.  Let them know you are there when they need you.
  • Set age appropriate limits:  For younger kids, for example, they need to stay in line so the teacher knows where they are. Explain why teachers have the expectations that they do.  For older kids, develop contracts or agreements to let them know you respect their safety and their space.
  • Show empathy and caring:  For all kids, no matter their age, it’s vitally important that we as parents respect their needs and treat them as people of value.  In the long run, this is what helps them handle strong emotions.
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From “A Sensory Life”: Homework Success

You are probably already starting to have some homework battles at home.  It’s a great idea to spend some time planning for homework success for your child.  This means:  Where are they going to do it? When?  What equipment do they need?  What strategies work best for my child?  This article is from the “A Sensory Life” blog that has lots of great ideas.  We are happy to help you figure out a way to set up your child for success when they are doing their homework.  Just ask!





The sensory strategies below apply to ALL children, and are of utmost important for those with sensory differences.  After a long challenging day at school,  the last thing a child needs is homework…but since I can’t do anything about that part, I will do what I can do, which is provide sensory solutions!  Two things to keep in mind: 1. The brain and nervous system are still sorting out and processing all of the multi-sensory input from the school day, so insisting on homework to be complete the minute a child gets home is probably the worst thing you can do for the brain.   2. It is critical to give the brain time to sort out and decompress, THEN re-boot the brain by sensory activities to maximize attention to task, executive functioning and cognition, and to make the homework process efficient and a success!


  • Give the child a break!  At least 30 minutes of free sensory play when they arrive home from school, and this does not count screen time (That can perhaps be the reward after homework)
  • During the 30 minute break, offer various sensory activities, primarily vestibular and proprioceptive 
  • Also suggest resistive sucking and blowing games prior to homework such as a bubble mountain
  • Offer a crunchy or chewy snack during homework or drinking something resistive through a straw, such as a smoothie or even yogurt or pudding
  • Offer chewing gum during homework or another oral sensory tool
  • Be sure homework is complete in a quiet area, not in the kitchen or living room..unless you can be sure it will be quiet and distraction free
  • Allow the school work to be done on a clipboard while sitting in a squish box or in another sensory retreat with adequate lighting
  • Offer earplugs or noise cancelling headphones during homework (even when in a quiet place) as the sound of the fan or noises outside can be enough to disrupt sensory processing for those who have difficulty filtering out auditory input
  • Try using a vertical surface for any written homework, such as an easel or even taping the work to a flat surface on the wall.  You can also encourage using a chalkboard or dry erase board for working out math problems and such.
  • Use an indoor or outdoor swing or trampoline for working on memory type homework such as studying for a test or for studying a spelling list
  • Use a ball chair instead of a standard chair
  • Place Theraband or other resistance bands around the base of the chair for pushing and pulling with the legs, or wrap over shoulders for deep pressure and resistive work with the arms. The resistance bands can also be wrapped around the arm of the chair.
  • Another alternative is laying prone on elbows for working on homework, especially when reading
  • Never allow homework to be done with the TV on in the background
  • Offer tools such as a weighted lap pad or vibrating pillow to be used during homework
  • And how could I forget, a fidget toy of course!
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The Blog is now back from summer break!!

summer break

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Handwriting is something that OT’s work on with kids regularly. This article explains simply why we do, what to look for and what we can all do to help.

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High Energy Kids Meet Low Energy Moms

Loved this post from Miriam Manela at Thrive Occupational Therapy. See if you can use any of her suggestions.

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