Advanced Pediatric Therapies


Getting a Handle on Screens

It’s so hard to manage.  Parents today may not have even had smartphones as kids and now, bam!  They are forced to reckon with those little glowy things that no kid ever wants to put down.

According to the American Heart Association, kids 8-18 spend an average of 7 hours per day in front of a screen.  7 hours!  This includes time in front of phones, laptops, tablets and televisions.  The AHA also recommends that parents actively limit screen time to 2 hours per day for older kids and 1 hour for kids age 2-5.

apple applications apps cell phone

Photo by Tracy Le Blanc on

Why?  There is increasing evidence that kids are spending so much time in front of screens that their obesity rates are increasing, as well as other health indicators such as cardiovascular disease and high cholesterol.  Kids don’t spend nearly as much time outdoors, moving their bodies or in face to face interactions with peers as in generations past.  This is all very worrisome but…how do you do it?

First, start with a media plan for the family.  You can find a link to it provided by the American Academy of Pediatrics here. The newest IOS on Iphone also have screen time monitors on phones that tell you exactly how much screen time each user is racking up.

First of all, you have to model this!  I so often see parents who complain about how their kids are addicted to technology as the parent is texting while they are talking.  You are your child’s first teacher, remember?

Next, find out more about what kinds of apps and games your kids are playing.  Is it all up to your standards?  Educate yourself about ratings and violence.  Some tech companies do not make this easy for parents, but it’s worth the effort.

Do you have times in your family where you do a “digital detox“?  Do you have times where no one is allowed to be on their phones or on screens?

Talk to your kids about screen time.  Set up a family meeting where you can all discuss it together.  This means kids will have opinions which you must listen to, but you may have to override.  In any event, everyone gets a chance to express their opinions but also agree on solutions. Expect some eye rolling from teens, but be honest.  Let them know you will follow the same rules.

Set up an exchange.  So you want a little screen time?  First you have to do your chores, get some exercise or play with your sister.  Make sure the rules are clear.

Most of all parents, remember that sometimes things change (when kids are sick, when YOU are sick etc.).  Try to be flexible and understanding.  These things aren’t going away and we need to try to find a way to live with them in a healthy way.

What helps you set limits on screen time?

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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!


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Homework Success!!

In the clinic lately, I have heard lots of complaints from parents about homework.  Homework, it seems, is the new “witching hour.”  Parents are telling us how hard it is to get kids to sit and do their homework and how moms and dads want to pull their hair out, arguing over who gets homework duty.  Well, that’s no way to live!  Here are some ideas to help get your kids to do their homework without needless stress.  Thanks to A Sensory Life for some of these ideas.

1.  Allow your child to get situated when they get home from school.  This means about 30 minutes of transition time (without you bombarding them with questions about their day).  It should be a time to clear some mental space, rest and have a healthy snack.

2.  Rotate where homework is done.  If it’s at your kitchen table every day, that spot will evoke anxiety.

3.  Refrain from ideas like “sitting” to do homework.  Your child may do their best when they are standing, lying down, however they want to be.  Sometimes I tell my own kids to put their heads upside down so all their ideas can travel easily to their brains.

4.  At the risk of stating the obvious:  make sure you have good lighting, maybe some nice background music, minimal clutter and an open mind.

5.  Offer some bubble gum, popcorn or other mouth work.  These are known to help the brain to focus.

bubble blowing

bubble blowing

6.  Think about having your child take some movement breaks.  Tell them you will work for 5 or 10 minutes, then do something stimulating like spinning in a circle ten times or ten jumping jacks.  It should be something fairly rote so that it doesn’t interfere with what they are thinking about for their homework.

7.  Some kids do well with white noise like a fan, while others may need headphones.  Some kids, especially older kids, like to listen to their favorite music.  Don’t say no right away.  Experiment.  It may just work!

8.  Experiment with using vertical surfaces like an easel with a therapy ball in front of it.  If it’s paper and pencil, just tape it to the easel.

Vertical surfaces with a balance-challenging surface.

Vertical writing with a balance-challenging surface.

9.  Your child may also want to lie on their stomach or their side for part of homework time.  If you have stools at a counter maybe have them put one hand on each of two stools and do push ups between written work.  Regular chairs with arms are good spots to do chair push ups too.

10.  There’s also all the nifty go-to OT options like using thera-band on the legs of the chair, weighted pillows/toys and fidgets.  Ask your OT if you are not familiar or need an idea where to go next.

11.  One of the kids I work with has found a large box to be the perfect spot to get some work done.  What a great idea!  How awesome is this?:

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Autism Explained- by a 13 year old boy

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The book “The Reason I Jump” is written by 13 year old Naoki Higashida.  Diagnosed with autism, this mostly nonverbal young man used an alphabet grid to write the book.  It’s incredibly honest and both heartwarming and heartbreaking.  The book is broken up into snippets with headings like, Why don’t you make eye contact when you are talking to people?  or Why can you never sit still?  The author describes feeling scared, overwhelmed and losing his “sense of gravity” often and that is the reason he jumps.  It’s a powerful and thought provoking read, as you can see from all the sticky notes sticking out of my copy.  It will change the way you see and think about someone you love with autism.

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Welcome to the Advanced Pediatric Therapies blog!

Welcome to the new Advanced Pediatric Therapies blog!  Please refer to our website for information on our clinic including our staff, location and how to find out if APT is right for your child.  Our goal is to provide a forum that not only tells who we are and what we do, but also allows for fun, community and active engagement.  Please let us know if there is a topic you would like covered in the blog.  We want you to be part of it’s development.

So let’s get started!

We thought we’d tell you about the phenomenal weekend we spent with Patty Oetter.  Patty comes to us from a private consulting practice in California and is well known to OT’s as the founder of the MORE (acronym for motor components, oral organization, respiratory demands and elements of toys that can be used to promote all of them) program.  She has an easy and natural way with kids that makes them feel instantly comfortable.  It may seem unusual, but Patty tells us that the mouth is the starting point of development throughout the rest of the body.  We spent the weekend with not only all of us at APT but other local OT’s who gathered to hear Patty’s pearls of wisdom.  We all came out rejuvenated and ready to share our knowledge with all of you!  We want to thank the families who brought their children in to us for Patty to treat and also all our OT friends who came and helped make the weekend such a fun and educational one.

Patty helps EJ jump from the platform for the very first time!

The OT’s are the ones watching for a change…

Patty is the author of “M.O.R.E. Integrating the Mouth with Sensory and Postural Functions” which has a companion DVD.  At the course, we learned techniques for use of oral motor intervention strategies, respiratory strategies and postural development.  We also were reminded about the healing power of touch and the importance of the energy we feel from each other in the therapeutic process.   Ask your therapist for more information.  The most important thing we learned from Patty is that you have to work from where you are and not try to jump ahead too quickly.  That way all kids are able to feel successful.

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