Advanced Pediatric Therapies


Back to School!

Forgive me!  APT has been hard at work all summer, but your blog writer has taken a brief reprieve to soak up some rays and take some time with her own kiddos.  Rest assured, the blog is not forgotten and welcomes your ideas.

It's Back to School Time!  (photo courtesy of edulicious)

It’s Back to School Time! (photo courtesy of edulicious)

It’s nearly that time:  Back to School!  Based on how your summer has been, you may or not be cheering right now.  We wanted to give you some ideas for how to ease the transition back to school for you and your children.

1.  You know the drill:  Routine, routine, routine!  For the week before or at least a few days before your child goes back to school, keep a good predictable schedule of meals, bath tiime and bedtime.

2.  Let your child take part in purchasing school supplies.  Let them handle the supplies before you buy them and before school starts so they are not distracted by that awesome new folder or that pencil that clicks.  You can go during off times to reduce overload.

3.  Oh those new school clothes!  Kids get so excited about wearing their new duds, but for our kiddos, it may be better to let them wear those new clothes once or twice before school starts in case there are any problems with fit or comfort.

4.  Does your child need an eye exam?  Lots of fine motor or coordination problems can be traced to visual problems.  If you need a referral to a pediatric opthalmologist or developmental optometrist, let us know.

5.  If your child is entering kindergarten or going to a new classroom or has trouble with new teachers, it’s a great idea to to touch base with your child’s school before school even starts.  Many schools have kindergarten prep classes, start-up or other programs to help ease the first day jitters.  Meeting that important new person before the first day can be very helpful.

6.  Parenting for Special Needs has a great form called “Getting to Know My Child” that can help your child’s new teacher learn about your unique child.  Check it out here.

7.  An OT, Lesley Biehl, created a checklist for parents which may help your the classroom staff identify areas which can be adapted for your child.  You can download it here.

As always, you can ask any of the staff at APT for help with back to school transitions.  Encourage your child to be curious, and be open to having fun!


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Help! Recess is a Challenge

Recess is necessary, but can be challenging for some students.

Recess is necessary, but can be challenging for some students.

As we are well in the midst of back-to-school, the topic of recess comes up often.  As OT’s, we are huge proponents of recess primarily as a movement break to help the brain stay active and engaged.  For some kids, particularly those with autism, recess can be problematic.  Excerpted below is a great article from  Some of the ideas may be useful for kids who don’t have autism, but consistently have problems at recess.

Autism and Recess

Most kids just can’t wait for the bell to signal that recess has begun. For many, this is one of the highlights of the school day. For children on the autism spectrum, however, it can be very difficult. Aspects of this period of the day that can wreak havoc on an autistic student are:

  • Lack of structure
  • No expectations
  • Little or no direction or guidance
  • Social interactions dominate
  • Multiple sources of sensory input

Students on the autism spectrum sometimes do better in a structured classroom because:

  • There is a structured routine
  • Expectations are clearly communicated, often with visual aids
  • Teachers and aides offer direction and guidance
  • Academics and instructions dominate
  • There is limited sensory input

Other Considerations

Children with autism may feel overwhelmed, uncomfortable and downright frightened during breaks, lunch and playtime because there is little or no sense of order and control. Sensory overload can be difficult to tolerate and other students may not understand the reactions and behaviors of autistic students. Dealing with recess and autism may seem like a hopeless situation, but each of the problems can be addressed in ways that create loose structure during play activities. Consider the following when developing a plan:

  1. Many kids with autism have to learn how to play
  2. Many want to interact but they just don’t know how
  3. Sensory input can be controlled
  4. A little guidance goes a long way
  5. Many typical students are happy to help
  6. It’s okay for a student to play alone for awhile

Creating a Recess Plan for Autistic Students

The first step in creating a recess plan for a student with autism is to get his parents involved. Recess skills can be included in part of his treatment plan and this requires all members of his treatment team to be on board, including parents. Specific goals can be outlined and interventions put in place.

Creating Structure

The last thing most kids want is to be given directions during recess, but students with autism often like knowing what to expect. Simply offering a choice between swinging and jump rope is a great start. This relatively simple step sets up the child’s expectations. Some kids can benefit from aids like:

  • Picture schedules specifically for recess
  • Stories about recess activities
  • Favorite outdoor toys and activities
  • Social skills and play guidance

Buddy Systems

Many typical students are happy to encourage their autistic classmates to play. Teachers can reward guides with extra credit or “helper certificates”. With guidance, buddies can:

  • Use picture schedules
  • Give verbal and visual cues
  • Serve as a model for appropriate behavior
  • Give reinforcements through praise
  • Offer encouragement

As regular students interact with children on the spectrum, they learn to become comfortable with and appreciate their classmates’ unusual ways of doing things.

Sensory Situations

Sensory overload is uncomfortable and too much input may be overwhelming for some children. Try creating a balance by giving a student with autism a recess schedule that alternates active, loud activities with ones that offer sensory release. Keep in mind that recess is an excellent time for sensory play. Some activity ideas are:

  • Shaking rattles
  • Playing in sandboxes
  • Bouncing on an exercise ball
  • Climbing
  • Playing on slides
  • Running, jumping, spinning, stomping
  • swinging

Recess offers excellent opportunity to help improve muscle tone while promoting good health through exercise.

Schoolyard Bullying

Bullying is a considerable problem across the board, and kids on the spectrum may have difficult defending themselves because of a possible lack of communication and social skills. However, the focus here is on the child with autism, not typical students. In many cases, the student on the spectrum is the aggressor.

In some instances, negative behaviors may be inadvertently rewarded. For example, it is Sally’s turn to be first in line to go outside. James, who has autism, gets in line in front of her and when the teacher guides him back to his place, he drops to the floor, screaming. The teacher in an effort to keep order in the class decides that it isn’t a battle worth fighting and allows James to get in front of the line.

The decision to let James have his way does stop the negative behavior and the class can continue on schedule without incident. However, the decision is counterproductive because he has learned that the negative behavior works in his favor, which increases the likelihood that he will repeat it. In addition, Sally receives a subtle message that James is favored, as does the rest of the class.

Instead, make sure that:

  • The same rules apply to all kids
  • Behavioral expectations are clear
  • Consequences are meaningful, immediate and consistent
  • A crisis management plan is in place

Reccurring aggressive or bullying behaviors an also be dealt with in the child’s treatment plan so it is important that any significant incidents are documented.

Learning How to Play

Perhaps recess and autism is such a challenging pair because kids on the spectrum often have to earn how to play, as other children have to learn how to do math. What better time to learn how to play than during recess?

Let your therapist know if you have found good solutions with your school for recess-related problems.  We’d love to share them with other families!
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