Sensory Approach to Home
So we’ve talked about sensory processing in previous posts; But we wanted to add some tips for different situations parents may be experiencing!
This is applicable to:
Autism Spectrum Disorders
SPD (Sensory Processing Disorder)
ADHD, Down Syndrome
Cerebral Palsy
Developmental Delays
Motor Delays
Gifted and kids who are Twice Exceptional
Anxiety
Typical children
Just as an overview, kids should typically get a thorough evaluation, and/or neurology consult before being diagnosed. Many children who are SPD and are sensory seekers/cravers, or those with poor postural control may look like they have ADD/ADHD. The issue at times doesn’t stem from the attention. A lot of the times we think these kids are acting out, not listening, or not paying attention. We notice when they get sent to principal's office, trouble with virtual learning, or get labeled the “behavior kid.” But looking deeper into the underlying issue with the help of healthcare professionals will have a more thorough diagnosis.
In order to help children feel more balanced we can create a Sensory Lifestyle Previously termed a “Sensory Diet,” it’s how you incorporate the sensory tools that you have into every day life. Every child is different, so depending on the child’s sensory processing we advise activities and strategies, but its best to learn through trial and error what works best for the child you are working with.
How does Sleep affect your Child?
Sleep can be very important, keeping consistent bedtime routines, comfortable bedding. You can add some calming music or lights, try to have them sleep in their own bed, tents over the bed can be calming, as well as body pillows.
What about Diet?
You are what you eat. If you have concerns about your child’s limited food repertoire or “picky eating” seek out a therapist who is trained by Dr. Kay Toomey SOS Approach to Feeding. It’s suggested that children need at least 10 sources of protein, 10 fruits or vegetables, 10 other/starches for a total of at least 30 different foods
Dinner time tips:
Family style dinner
Make Eating Fun!
Try different textures, colors, smells
Have something preferred for after the child touches or tastes a new food
Always present a protein source, fruit or vegetable, and starch at every meal/snack, plus one preferred food
Don’t allow your child to “food jag” eat the same foods over and over again
If they have chicken nuggets on Monday, they can’t have them again until Wednesday
OT’s Role:
Among the psychosocial conditions, anxiety disorder is the third prevalent mental disorder affecting children aged 3-17 years (CDC, 2019). OT’s are a great resource for therapy for implementing evidence-based mental health promotion, Emotional Regulation, Executive Functioning, Mindfulness, Yoga, etc.
Calming Strategies:
Taking Deep Breaths
Drinking through a straw
Sucking on hard candy
Taking a break
Lowering the lights
Calming music
Warm bath
Talking in soft voice
Slow linear swinging/rocking
Chewing gum
Deep pressure/hugs/weighted vests, blankets
Mindfulness is defined as a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations. This is used as a therapeutic technique. This is all about living in the moment and taking every moment just as important as your last.
Want to know more? Email us!
References
Aguilar, Del; Esposito, Phil (2019) “Sensory Processing Disorder and Praxis Skills in Children With Learning Disabilities” The American Journal of Occupational Therapy, Vol. 73, No. 4 2. Liotta-Kleinfeld, Lorry; Beros, Lynsey; Boyer, Andrea; Boggus, Taylor; Ruff, Madeleine; Little, Mary; Sollman, Rachael (2020) “Incidence of and Relationship Between Tactile Sensitivity and SelfRegulation in Six- to Eight-Year-Old Children” The American Journal of Occupational Therapy, August 2020, Vol. 74 3.
Lin, Mei-Ling PhD, OTR/L; Nasser, Alyse; Molina, Cayla; Smith, Emma; and Millar, Kristin (2020). “Mental-Health Benefits of a Mindfulness-Based Prevention Program on Elementary Schoolchildren” The American Journal of Occupational Therapy, August 2020, Vol. 74, Supplement 1 4.
Mulligan, Shelley; Schoen, Sarah A.; Miller, Lucy Jane; Valdez, Andrea; and Magalhaes, Deborah (2019) "The Sensory Processing 3-Dimensions Scale: Initial Studies of Reliability and Item Analyses," The Open Journal of Occupational Therapy: Vol. 7: Iss. 1, Article 4. 5.
Orley Templeton, OTD, OTR/L1, Lori Charney, OTD, OTR/L1, Heather Bennett, MS2, Molly Betz, MS3, Kelly Byrne, MS, OTR4, Jame Duffy, MS2 (2019). “The Effect of Sensory-Based Strategies and Social-Skill Training on Social Skills Among Preschool Children With Autism Spectrum Disorder” The American Journal of Occupational Therapy, Vol. 73, No. 4
What Parents Need to Know About School Based OT
First, what is OT?
American Occupational Therapy Association describes it as a health profession in which therapists and therapy assistants help individuals to do and engage in the specific activities that make up daily life. For children and youth in schools, occupational therapy works to ensure that a student can participate in the full breadth of school activities—from paying attention in class; concentrating on the task at hand; holding a pencil, musical instrument, or book in the easiest way; or just behaving appropriately in class.
How does it apply to school?
We work with kids of all abilities. Some diagnoses include ADHD, Autism Spectrum Disorder, Sensory Processing Disorder, and in general; children having a hard time participating in the classroom. We can work with children inside the classroom (push-in) or outside the classroom (pull-out). Most kids that I provide OT to will already have had an Individualized Education Plan (IEP) that has been receiving services from a young age, and has a system in place that will support them to succeed in schools. Others may receive OT because they are having a specific problem in school. We also work in a team based profession to collaborate with interdisciplinary members, providing consultation to teachers about how classroom design affects attention, why particular children behave inappropriately at certain times, and where best to seat a child based on his or her learning style or other needs. A child might also be referred for OT for other reasons like motor skills, cognitive processing, visual or perceptual problems, mental health concerns, difficulties staying on task, disorganization, or inappropriate sensory responses.
Occupational Therapists tend to be the handwriting experts in school based settings because we specialize in fine motor and visual perceptual skills. OT looks at the child’s skills and other problems (including behavior), in addition to his or her visual, sensory, and physical capabilities. We also take into account the school, home, and classroom environments to find ways to improve the handwriting.
Students with disabilities have been able to benefit from occupational therapy at school since the 1975 passage of the Individuals with Disabilities Education Act (IDEA), and even more recently In 2004, the reauthorization of IDEA extended the availability of occupational therapy services to all students, not just those with disabilities, in order to fully participate in school (AOTA).
Helping Kids Regulate Behaviors
Long story short; Occupational Therapists help people recover and regulate. Among the psychosocial conditions, anxiety disorder is the third prevalent mental disorder affecting children aged 3-17 years (CDC, 2019). So our mindset is built around evaluating the situation and helping people adapt. Here are some tips to help those little ones (and even adults) regulate:
Sleep is Key
Keep a night routine to keep consistent
Comfortable bedding. This may include a weighted blanket at first, but we don’t recommend weighted blankets all night.
Calming Music/Lights
Having the child sleep in their own bed, a tent over the bed may make it more fun.
Body pillows can help with giving your child some comfort.
Nutrition
Eating healthy is important for function.
If you have major concerns about your child’s limited food repertoire or “picky eating” seek out a therapist who is trained.
Children are recommended to have 10 sources of protein, 10 fruits/veggies and 10 other/starches
Making a total of about 30 different foods
Helping Regulate You Child
It sounds simple; but watch their facial expressions and body language.
Try not to overwhelm with an activity, possibly ending up in a shutdown.
On the other hand, also try to pay attention to their arousal level. Limit an activity that’s getting them so wound up that it’s hard to get them back down.
If they’re at a meltdown, try calming activities that seem to work for them.
Where does OT Play a part?
OT’s are a great resource for therapy for implementing evidence-based mental health promotion for: Emotional Regulation, Executive Functioning, Mindfulness, Yoga and more!
If you have questions, please feel free to reach out to us at smplytherapy@gmail.com
What is Pediatric Teletherapy?
I still remember the first time I heard about Teletherapy (sessions via video); It was about 5 years ago and a coworker was talking about doing it part time for speech therapy. My first instinct was, how does that help kids?!
Many things that happened in 2020 seemed unimaginable to our 2015 selves, but here we are! There are many pros to teletherapy, I can’t say it’s for everyone but for many families it allowed for a closer educational relationship with the therapist. A huge part of Occupational Therapy focuses on training parents and families to assist their child progression, and doing teletherapy facilitated that.
So let’s go though some activities for great (middle school aged) teletherapy sessions!
Meme writing: You can share a funny picture to start. They can work on typing or writing, and it also works on executive functioning.
Online Games:
Bamboozle.com
https://jeopardylabs.com/
Escape Room: You can share a google doc, powerpoint or a word document. Some activities can be solving trivia, gross motor activities, fine motor activities, locating items.
Fantasy Sports Team: This is great for kids that are into sports, they can choose players. Names and stats can be listed on a shared word document. They can also add mascot, colors, uniforms, stadium name if they like.
Virtual Field Trip: The student can choose country, landmark or venue to tour. They can add pictures and videos to a google slide or power point and present to Field Trip Participants (OT, teacher, family members).
Newsletter: On a shared document, the student can research a topic (ex: sports trivia, gaming tips, recipes) and write a report.
If you need more ideas or you would like to schedule a consult, please email us at smplytherapy@gmail.com.
Clothing Preference for Sensory Sensitivity
Last week we spoke about how sensory processing may affect clothing choices; we want to go a little more in depth about it this week. As with many things, there is a spectrum of choices when it comes to the clothing we wear. Some like clothing fitted, others like them loose. Let’s go more in depth about those that enjoy clothing that are on the light side.
What do you mean by spectrum?
In terms of preferences for sensory processing; there is sensory seeking and sensory avoidant. In other words, there are some people that like clothing to feel like they're really present with extra pressure, and those that don't want to feel any pressure on their skin. Those are the two extremes, and most people fall within the spectrum that lies between the two.
Tactile Defensiveness
Have you ever had a child that cannot handle shirt tags? They find it itchy, and always feel like the tag is there, this is the sensitive end of the spectrum for sensory processing when it comes to clothing. They might also have difficulty with hair cuts, ticking may be overwhelming, they might be picky about certain textures, and they might like to keep their hands clean. Tactile defensiveness is basically an over-sensitivity to touch.
Some Tricks
This might make your child’s dressing routine difficult, and they might be repeating one item that is hanging on by a thread because it gets used so much.
One trick is to layer with the favorite fabric on the closest layer to their skin.
Depending on their preference, those with clothing sensitivities will like the light and soft type of fabric that makes it feel like it’s not on your skin.
You can also desensitize the specific areas that bother the child with deep touch, massage, or gently pressing around the area with a hand held vibrator.
Try second hand clothing that’s a little more worn in.
Moisturizing the skin may help, making the skin a little more sensitive.
Buying sensory friendly clothing with brands that understand clothing sensitivities
As always, we are here to help you with any questions. If this is a topic that you would like to explore more, email smplytherapy@gmail.com to speak to us!
Sensory Processing Relating to Clothing
We’re talking about something that everyone deals with to some degree, but may have not taken much notice… sensory processing as it relates to clothing! Just like picky eating relates to how we process our environment- the texture, flavor, or color choices in food; children may be picky about the clothes they wear.
If we’re being honest, most of us choose clothing differently whether it’s based on texture or how it makes you feel, and may be able to think back to their childhood when it was a little more “picky.” But for some kids, it may go to the extreme due to sensory processing difficulties.
Prevalence
Sensory processing disorder affects about 8.3% of 8 year olds internationally (Jussila et al., 2020), and 1 in 20 to 1 in 6.25 in the US (Ahn et al., 2004; Ben-Sasson et al., 2009), some experts say as much as 10% of kids. For children with ADHD; it’s as much as 40-60%, so children on the Autism spectrum and those with ADHD may be at higher chance of having difficulty with sensory processing.
Many children may not get a diagnosis, or have issues with sensory processing that affects their ability to perform daily activities. It may just be a quirk that allows them to function in society without too much difficulty, but clothing can still be something that assists feeling more balanced. Some children prefer tighter clothing, others want clothing to feel very light. With this; parents may find a pattern with their clothing shopping if their sensory processing takes priority over different styles and trends.
If your child is having trouble with tolerating clothing, and it’s affecting their participation in school or daily activities; We’re happy to help you understand and talk to you about it. Please feel free to email us at smplytherapy@gmail.com
References
Jussila K., Junttila M., Kielinen M., Ebeling H., Joskitt L., Moilanen I., et al. . (2020). Sensory abnormality and quantitative autism traits in children with and without autism spectrum disorder in an epidemiological population. J. Autism Dev. Disord. 50, 180–188. 10.1007/s10803-019-04237-0 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Ahn R. R., Miller L. J., Milberger S., McIntosh D. N. (2004). Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. Am. J. Occup. Ther. 58, 287–293. 10.5014/ajot.58.3.287 [PubMed] [CrossRef] [Google Scholar]
Valentine's Day and Chinese New Year Activities
Even if you’re not the most spirited person to celebrate; these activities are just another way to get creative with your little one! We have a couple holidays this week- Lunar New Year and Valentine’s Day. Two very different celebrations but we figured we’d give you some ideas to have fun this week.
For Valentine’s Day Celebrations
Celery Heart Stamps: Use the ends of the celery stick as a stamp to dip into red or pink paint for a heart felt painting.
Ribbon Valentine: Something about Valentine’s always makes me flash back to Billy Madison getting one from Principal Anderson. Since kids are less likely to be able to pass it along to classmates, make ones at home for family members! You can use pieces of already used ribbon from Christmas to paste onto a heart, for a striped design.
Valentine Name Puzzle: This is a double task; they can make the valentine with their name displayed across it. Then if you draw jagged lines across or even in squares, they can put it back together like a puzzle!
Paper Heart Mobile: Use different colored construction paper to cut outlines of hearts, then attach them upright onto a string hanging from the ceiling.
Valentine Collages: if you have colored tissue paper, and a paper plate- make a collage! Add your own design by cutting the tissue paper into pieces that you can glue onto the paper plate. Then cut out a hearth to display on the window sill.
For the Lunar New Year Celebrations
Red Envelopes: This might be for the older kids, or adult assistance. https://www.firstpalette.com/craft/chinese-red-envelope.html
Paper Fans: You’ll need 3 5X8 inch pieces of paper, two craft sticks and an tiny hairband. Here are some instructions with pictures: https://www.littlepassports.com/craft-diy/chinese-new-year-craft/
Paper Lanterns: This is another activity that will require some adult assistance if for the younger kids. Here is a great how-to site https://www.firstpalette.com/craft/paper-lantern.html.
Printable Chinese Zodiac Animals: Here’s a Free Printable! https://funcraftskids.com/wp-content/uploads/2020/12/12-Chinese-Zodiac-Coloring-Pages.pdf
For more fun ideas, you can always email us at smplytherapy@gmail.com!
Snow Day Fun!
This blizzard has its pro’s and con’s; adults got their workouts in with all the shoveling, even if they were also target practice for little ones making snowballs. As we’re getting our buried cars out of the driveway, we might want to spend the rest of our times indoors. But when it comes to kids, it can be their favorite part of winter! Snow brings a new set of activities and creativity that doesn’t come so often in the tri-state area. It’s also a plus when kids can make a mess outside and keep it outside for a little while.
Here’s a list to get you started:
Snowman with sticks and stones- You can always go traditional with an old hat and carrot, or you can make it a part of the challenge to find things in the backyard as additions. Finding stones and branches to make eyes, limbs and hair.
Backyard Ice Sculptures- All you need is a water bottle, ice cube trays, water and food coloring. Mix the water and food coloring in a bottle and let them freeze. Once frozen, you can gather the colored ice gems to make sculptures in the yard.
Maple Syrup Snow Candy- This requires some cleaner snow beds; but if you boil maple syrup and pour it onto a bed of snow, it’ll turn to taffy! Use wooden popsicle sticks to keep the maple syrup on and eat.
Snow Sensory Bin- Gather some of your child’s favorite toys and place them in a bin of snow to keep track of them.
Paint the snow- Exactly what you think, use paintbrushes and the lawn is their landscape! You can even adapt with food dye drops and do a more abstract colors scheme.
Homemade Bird Feeders- Use some orange peel halves, fill with snow and put some bird feeder at the top!
I hope these help you get creative! As always, we’re here for your questions, please email smplytherapy@gmail.com.
What is Sensory Diet?
A sensory diet is a set of activities that make up a sensory strategy and are appropriate for an individual’s needs. These are specific and individualized activities that are scheduled into a child’s day and are used to assist with regulation of activity levels, attention, and adaptive responses. It has nothing to do with food!
Why use a sensory diet?
It can be very motivating for a child and help them participate in activities. It's a means to adjust sensory input in relation to an individual’s needs. Based on the the child, we will prescribe some activities to incorporate into your routine. As we evaluate what activities are meaningful and motivating for your child, we will curate a child centered approach that is unique to your child.
Just as a healthy diet consists of a spectrum of foods, a sensory diet is a balanced set of sensory information that allows an individual to function. A person cannot survive on broccoli alone. Similarly, a child cannot thrive with only one type of sensory activity.
This goes for adults and children alike; we all need different types of input in order to feel balanced; part of the reason quarantine restrictions are not great for most individuals. Our bodies and minds instinctively know that varying sensory input allows us to function appropriately. However; children may have a harder time regulating and identifying what their bodies need. That's when OT's come in.
Studies support the use of active participation in multi-sensory activities for at least 90 minutes per week to improve occupational performance (Fazlioglu &Baran, 2008; Thompson, 2011; Woo & Leon, 2013; Wuang, Wang, Huang, & Su2010).
GOALS OF A SENSORY DIET ARE TO:
Provide the child with predictable sensory information which helps organize the central nervous system. Support social engagement, self-regulation, behavior organization, perceived competence, self-esteem, and self-confidence. Inhibit and/or improve modulation of sensation within daily routines and environments. Assist the child in processing a more organized response to sensory stimuli.
If you want to learn more, schedule a free consult with us here
Making the Most of Your Holiday & Giving to Those in Need
This season is one of my favorite times of the year; the best movies are playing on tv, there’s some meaning behind making certain foods and baked goods. But let’s be honest; it’s been a little stressful this year. So I wanted to take this week to try and remind families that the holidays don’t have to go perfectly. But here are some tips to help deal with expectations that the holiday may bring.
Take some time out for yourself. Restorative time. I know it’s easier said than done, but it’s important to set aside 15 minutes or so for yourself and also for children to have their own time to pick an activity. This can help decrease stress and provide a sense of security. It can be reading a book together, play a game, or working on a project.
Remember: when parents are stressed, children’s stress levels increase as well, so quality alone time for parents is also important.
For holiday times- set reasonable expectations:
Pinpoint your children’s stressors and needs will help structure your expectations during the holidays.
Example: If noise is your child’s stressor, shopping will be difficult, consider earphones or use an app with mindfulness/calming scripts.
You can also give your child some control in an environment where they feel stressed. Maybe offer a list to your child and have them be in charge of marking each item off. This can help with modulating arousal.
Make a list of anyone you wish to recognize this season and think of how you might like to express that (get creative with letters or phone calls) rather than a list of people you need a gift for.
Help children think about others in need – This is the perfect time of year for children to go through their toy boxes to select things they don’t use anymore. Ask your child to choose one or two toys that are still in good condition to donate to a shelter or even buy a new toy for a toy drive. Parents can explain that they will soon be receiving new toys, and it feels good to share toys with children who might not have many.
Creative Ideas for Giving:
Kiva combines microfinance with the internet, allowing you or your child to be a financial investor anywhere in the world. Kiva's mission is to connect people, through lending, for the sake of alleviating poverty and empowers individuals to lend to an entrepreneur across the globe. Your child can chose a project to invest in anywhere in the world. Small investments ($10) can make a significant difference http://www.kiva.org/
Oxfam allows you to purchase a unique and specific gift for a child or family in need. You can buy a child a desk ($25) or a family a goat ($75) – Oxfam has a catalogue you can shop form. www.oxfam.com
Heifer international’s mission is to end hunger and poverty and care for the earth. You can make a gift of livestock to family which, in turn, provides sustainable nutrition and livelihood for their community. www.Heifer.org
A penny is virtually worthless, but in impoverished countries a penny buys a pencil and opens the door to literacy. Greg Mortensen’s Penny’s for Peace program is a very rich way for children to make a huge difference in their small way. www.penniesforpeace.org
References: Using the Science of Sensory Process to Survive The Holidays Presented by Rondalyn V. Whitney, PhD, OTR/L, FAOTA
15 Ideas for Thanksgiving Fun!
In the spirit of thanksgiving quickly approaching, we wanted to list some great activities that will keep those little ones busy. Many of us are having a smaller get-together this year due to the pandemic, so why not add something to bring the family together in a fun way. We wanted to keep the activities budget friendly, and something that everyone can participate in. There may be some younger ones that need adaptations, but most activities will be good for a range of ages. I’ll also provide some links to help with printable versions for some activities.
Thanksgiving Themed Activities:
Thanksgiving Family Feud: This is is ideal for families for older kids and adults, I might add this to my family’s thanksgiving plans! https://www.playpartyplan.com/family-feud-game-questions-and-answers/
Feed the Turkey: You can make this using some recycled bottles, tongs from the kitchen, and pom poms (from the craft store) or even cotton balls from the bathroom. Add some colored paper wings to the bottle and a face to make a turkey, and place the cotton balls/pom poms on the table or floor. Encourage your kiddo with challenging her/him to do it as fast as they can, or making a race between siblings; use the tongs to get all the food into the turkey!
Thanksgiving Charades: Act out some thanksgiving themed words. https://www.thegamegal.com/wp-content/uploads/2011/11/Thanksgiving.pdf
Mini Pumpkin (or any holiday themed item) Scavenger Hunt: Whether it’s outside or around the house, this will be a fun game for any age.
Yam Race: It sounds ridiculous, but you might find it harder than you expected. Use a spoon to get a sweet potato or yam across the floor in a race.
Word Scramble: https://www.bigactivities.com/word_scrambles/thanksgiving/easy/thanksgiving1.php
Guess How Many: Put a bunch of candy corn in to a jar or clear container and see who comes up with the most accurate number!
Thanksgiving Kids Table Game: All you need is M&M’s, print out this template for $3.95, and some dice! https://www.etsy.com/listing/623356536/thanksgiving-kids-table-game-roll-a?utm_custom1=housebeautiful.com&awc=6220_1606167898_1a0f2d4d33bfafe58c05e87c138df6a0&source=aw&utm_source=affiliate_window&utm_medium=affiliate&utm_campaign=us_location_buyer&utm_term=3657&utm_content=78888
Thanksgiving I Spy: https://www.papertraildesign.com/free-printable-i-spy-thanksgiving-activity/
Taboo Thanksgiving Edition: This is one of my favorite games, it may be more favorable for older kids 11-13 and up advised. https://www.teacherspayteachers.com/Browse/Search:thanksgiving%20taboo
Baster Relay: use the turkey baster and a feather, see who can get the feather to the finish line the fastest!
This next one is more abstract for older kids; go around the room saying, “For Thanksgiving I had…” and list an item. The next person has to remember what the person/people before them said in order, and add another item for it to continue. It’s a memory game for all things food/ thanksgiving related.
Thanksgiving Bingo! https://www.happinessishomemade.net/free-printable-thanksgiving-bingo-cards/
Memory: Print out some Thanksgiving items in doubles, and attach them to some cardboard cutouts or cards to match!
Pumpkin Patch Stomp: blow up some orange balloons on the yard and have everyone try and pop them!
From my family to yours, I wish you a VERY happy Thanksgiving!
Potty Training Tips
Children will typically show signs that they’re ready to be toilet trained.
Signs of readiness can include:
Interest in visiting the bathroom
Pretending to use toilet paper and flushing
Wanting to observe others using the bathroom
Reporting to a caregiver that they have soiled their diaper
Getting upset when a diaper is soiled
Children typically begin to express these behaviors between 18 months and 3 years.
Your child is learning about their body and the cues it’s giving to them to know when to go. To help encourage this behavior, it’s good to set a routine for potty time.
Consistently encouraging toilet use at established times such as when waking up, before a meal, before leaving the house, and before bedtime, encourages routines. It’s also important to allow the child to initiate potty use; If you see a child who is squirming, wiggling, or grabbing their clothes if they need to use the bathroom is good, but it’s important for children to learn to recognize the cues their body is telling them and to go on their own.
Make toileting easy for toddlers. Dress the child in clothing that can easily and independently be removed and put back on. Go for elastic waistbands and avoid snaps, buttons, and overalls when potty training.
General Potty Training Tips:
Provide a comfortable and calm space
Keep toilet paper within easy reach and provide a stool near the toilet to help the child feel secure and confident.
Address the different noises your child will hear and explain how a toilet works to calm fears.
You can include a favorite book while on the toilet
Talk about the bathroom to reduce fear
Use scented soaps or fresheners to create a fun space
Adapt the toilet or the potty chair/ring as appropriate to help the child feel secure.
Be patient. Children may need to sit for a while, run water, sing a song, or look at a book to help relax and initiate toileting. When in a different bathroom, the time to use the toilet often takes longer because of fears or curiosity about a different environment. You can even post a series of pictures in the bathroom of the tasks they need to complete as a reminder.
They may need assistance on knowing how much toilet paper to use, coaching from parents. A sturdy stool may help adults with hand washing (less strain on you). Facilitating independence on even use of water faucets and access to towels will help their development, with also educating safety for hot/cold water.
Encourage positive behavior. Reward children for their participation with lots of praise. Remember that toileting accidents are part of the learning process.
Resource: https://www.aota.org/Publications-News/ForTheMedia/PressReleases/2015/021815-ToiletTrainingTips.aspx
Want to learn more or schedule a complementary consult? Set up a time here
Reuse and Recyclables to Make Your Child Able!
How many of us know about the child that receives a thought-fully planned present; only to find that little one playing with the box? Kids love using items in new ways! It also helps with things that are already in your home for a budget friendly activity, helping your family learn in the process.
Benefits to recycling:
Reduces waste
Conserves natural resources
Increases economic security
Prevents pollution
Saves energy
Supports American manufacturing
Helps create jobs
But, can you believe the recycling rate is only 35% (in the country)!
Here is a site to help with the basics: https://www.epa.gov/recycle/recycling-basics
Did you know recycling just 10 plastic bottles saves enough energy to power a laptop for more than 25 hours? Raising consciousness is important for all ages, to help our future. A study found that with increasing age and cognitive maturity, children's responses showed a marked change toward more awareness of, and more feelings of responsibility toward, conserving earth's resources if taught about it from a young age.
Some ideas for combining using reusable items for games and activities for fun:
Action Cube
Materials:
Cube shaped tissue boxes (As many as you like; the more you have, the fewer times you'll need to change the content of the sides of the dice)
Newspaper
Cardboard from a cereal box or similar box
Solid color paper (construction paper or brown paper bags)
A 4" x 6" photo album with plastic pages that can be cut out of the album – 6 pages needed per die
Scissors
Tape
Preparation:
Fill the tissue box with crumpled newspaper balls.
Cover the opening to the box with a piece of cardboard cut from a cereal box.
Tape the cardboard piece to the opening of the box.
Cover the box with solid color paper.
Cut out 6 pages from the photo album.
Tape one photo album page to each side of the box. These photo album pages allow the content cards to be quickly changed in and out, maximizing time and minimizing storage space. Slip one card into each photo album page on each side of the box.
Super Sock Ball:
Roll a clean sock from the toes toward the top of the sock. When you get to near the top of the sock, turn the last 2" inside out to secure the rest of the sock in a ball shape. For a bigger ball, use two socks.
Super Scoreboard:
Circular plastic container lid
Dry erase marker
Small felt square or an unmatched sock as an eraser
Tip: Use a hole punch to make two holes on opposite sides of the lid. Tie a 16" piece of yarn in each hole. To one piece, attach the eraser; to the other, attach the marker.
Bottle Bowling:
Materials:
Pins
Remove the labels from ten plastic bottles
Add water, dry rice, dry beans, or sand to each bottle to weigh them down and make it easier to stand them up when resetting the pins.
Math tip: Measure and/or weigh the contents added to each bottle or bowling "ball".
Bowling Ball
Each player selects a bowling "ball", choosing from coffee cans, a roll of tape, a ball, or cylindrical container. If needed, add weight to the coffee cans or cylindrical containers to make it easier to knock the pins over.
Score cards
Cut cereal box or granola bar boxes into index card size score cards.
Table Tennis:
Paddles (2): hard plastic lid (example: thick circular plastic lid (plastic coffee lid), foil pie plate) Ping Pong ball: examples: ping pong ball, crumpled paper ball or mismatched sock ball (2 Clean mismatched socks folded into a ball)
Table: a large box or a table
Tape (example: masking tape, painters tape)
Net: small cardboard items taped together (example: travel toothpaste boxes, paper towel rolls, jewelry boxes, small cereal boxes, etc)
Timer: electronic timer or homemade sand timer
Scoreboard
Containers of various sizes: tissue boxes, shoe boxes, large plastic tubs (examples: whipped topping)
2 action cubes
Hockey:
Hockey sticks: paper towel rolls, wrapping paper tubes, or mailing tubes
Hockey puck: small wide plastic container (example: margarine or soft cheese spread) or small thick plastic lid (minimum storage!) (Activity #1: 1 puck, Activity #2: 8-10 pucks) or lids (hard plastic- economy/wholesale pretzel/cracker/snack, coffee lid, ice cream lid)
Goal: 2 goals for Activity #1 and 3, 2-4 goals for Activity #2.
Option #1: 2 Liter Bottles (2), paper towel roll or wrapping paper tube (1), tape. (Tip: fill liters with a little water to weight down if needed)
Option #2: large shoe box or printer paper box turn on it’s side or upside down with a goal cut out of one side
Timer: electronic timer or sand timer
References:
Recycle Bin Bonanza: References: Amy Schlessman PT, DPT, DHS
Ardoy, D. N., et al. "A Physical Education trial improves adolescents' cognitive performance and academic achievement: the EDUFIT study." Scandinavian journal of medicine & science in sports 24.1 (2014).
Becker, Derek R., et al. "Physical activity, self-regulation, and early academic achievement in preschool children." Early Education & Development 25.1 (2014): 56-70.
Lees, Caitlin, and Jessica Hopkins. "Peer reviewed: effect of aerobic exercise on cognition, academic achievement, and psychosocial function in children: a systematic review of randomized control trials." Preventing chronic disease 10 (2013)
United States Environmental Protection Agency. “Recycling Basics.” Available at: https://www.epa.gov/recycle/recycling-basics. Accessed: June 13, 2018. United States Environmental Protection Agency. “Learning and Teaching about the Environment” Available at: https://www.epa.gov/students. Accessed: June 13, 2018. United States Environmental Protection Agency. “President's Environmental Youth Award” Available at:https://www.epa.gov/education/presidents-environmental-youth-award. Accessed: June 13, 2018. United States Environmental Protection Agency. “Reduce, Reuse, Recycle Resources for Students and Educators” Available at: https://www.epa.gov/recycle/reduce-reuse-recycle-resources-students-andeducators. Accessed: June 13, 2018. Witt, Susan D., and Katherine P. Kimple. "‘How does your garden grow?’Teaching preschool children about the environment." Early Child Development and Care 178.1 (2008): 41-48.
Expressive Art in OT
"Expressive Art is a process by which various art modalities are used as a catalyst for creative expression to enhance personal growth, awareness and healing."
We’re not talking about fine art; and using a piece to necessarily express yourself. Expressive art focuses on the process, and uses the technique for improvement. This includes;
Visual arts
This includes painting, drawing, sculpting, pottery, photography, printmaking, crafts and scrapbooking. There’s supportive evidence that says these types of art increases sensory input. Fingers and hands have tons of nerve endings which transmit to the cerebral cortex, enriching the sensory experience to help children with motor development. It also helps with self of self, self esteem and perception of control over a situation. Helps with perceptual skills, global cognitive function, and helps reduce cognitive decline in older adults with Dementia.
Drama & Storytelling
Projective play with dolls or puppet helps kids with creating a comfortable atmosphere to express feelings of the play subject (kind of like “asking for a friend,” but for kids). There’s also purposeful improvisation; where the child acts out a situation that may be relatable. This will help them with expressing themselves, because the character portrayed is typically themselves. Scripting may be used to help with speech related issues like Aphasia, where a client reads from a script of a favorite movie/show or song. Research shows that drama and storytelling results in improvements in self-worth, overcoming self-imposed limitations, and in self-advocacy. Props are less antagonistic and threatening, and can aid in communication. Multi-sensory storytelling can be used to improve retention and recall for individuals with intellectual disability.
Dance and Movement
Improves strength, balance, and proprioception with kinesthetic activity
Reduces depressive symptoms
Slows cognitive decline
Activates motor neurological brain regions to improve muscle memory
Reduces fall risk
Stimulates communicative capacities through shared experiences in dance
Music and Singing
Increase neuroplasticity
Enhance alertness, leading to improved attention and memory
Decrease depressive symptoms and improve motivation
Activate multiple parts of the brain, fostering dendritic sprouting and synaptic plasticity
The way Occupational Therapists can blend this into practice is to use some of the visual arts for table top activities, role play different situations (short story), role playing, using a mirror to show dance movements, expressive writing. Contact us for creative occupational therapy sessions!
References
Dunphy, K., Baker, F. A., Dumaresq, E., Carroll-Haskins, K., Eickholt, J., Ercole, M., Kaimal, G., Meyer, K., Sajnani, N., Shamir, O., & Wosch, T. 2019. Creative Arts Interventions to Address Depression in Older Adults: A Systemic Review of Outcomes, Processes, and Mechanisms. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2018.02655 2. Malyn, B. O., Thomas, Z., & Ramsey-Wade, C.E. (2020) Reading and writing for well-being: A qualitative exploration of the therapeutic experience of older adult participants in a bibliotherapy and creative writing group. Counseling and Psychotherapy Research. https://doi.org/10.1002/capr.12304 3. Masika, G., Yu, D.S.F., & Li, P. W. C. (2020) Visual art therapy as a treatment option for cognitive decline among older adults. A systemic review and meta-analysis. JAN, https://doi.org/10.1111/jan.14362 4. Matos, A., Rocha, T., Cabral, L., & Bessa, M. (2015). Multi-sensory storytelling to support learning for people with intellectual disability: an exploratory didactic study. Procedia Computer Science, 67. 12-18. doi: 10.1016/j.procs. 2015.09.244 5. Morris, J., Toma, M., Kelly, C., Joice, S., Kroll, T., Mead, G., & Williams, B. (2015). Social context, art making processes and creative output: a qualitative study exploring how psychosocial benefits of art participation during stroke rehabilitation occur. Disability and Rehabilitation, 38(7), 661-672. https://doi.org/10.3109/09638288.2015.1055383 6. Nguyen, M.A, Truong, T.K.O, & Le, T.H.D. (2016). Art therapy in combination with Occupational therapy in supporting children with special needs. The Vietnamese Journal of Education, 50-52. ISSN: 2354 0753 7. Osman, S. E., Tischler, V., & Schneider, J. ‘Singing for the Brain’: A qualitative study exploring the health and well-being benefits of singing for people with dementia and their carers. Dementia, 15(6), 1326-1339. DOI: 10.1177/1471301214556291
Roswiyani, R, Kwakkenbos, L, Spijker, J., & Witteman, C. L. M. 2017. The Effectiveness of Combining Visual Art Activities and Physical Exercise for Older Adults on Well-Being or Quality of Life and Mood: A Scoping Review. Journal of Applied Gerontology, 38(12), 1784-1804. 9. Schlaug, G. 2016. Chapter 81 – Melodic Intonation Therapy. Neurobiology of Language, 1015-1023. https://doi.org/10.1016/B978-0-12-407794-2.00081-X 10. Skidmore ER, Butters M, Whyte E, Grattan E, Shen J, Terhorst L. Guided Training Relative to Direct Skill Training for Individuals With Cognitive Impairments After Stroke: A Pilot Randomized Trial. Arch Phys Med Rehabil. 2017;98(4): 673-680. doi:10.1016/j.apmr.2016.10.004 11. Vik, B., Skeie, G., & Specht, K. (2019). Neuroplastic Effects in Patients With Traumatic Brain Injury After MusicSupported Therapy. Frontiers In Human Neuroscience, 13. https://doi.org/10.3389/fnhum.2019.00177 12. Whale, Rosann. "ARTs Story." https://www.arts-story.com/expressive-arts/ 13. Yuen, H. K., Mueller, K., Mayor, E., & Azuero, A. 2011. Impact of Participation in a Theatre Programme on Quality of Life among Older Adults with Chronic Conditions: A Pilot Study. Occupational Therapy International, 18(4), 201-208. https://doi.org/10.1002/oti.327
Primitive Reflexes in Child Development - Part 2
We’ve discussed Primitive Reflexes in previous blogs, today I’m going to get a bit more in depth. Before we talk about Primitive Reflexes, let's go back to neuro 101. The brain has different parts called the brain stem (kind of like the stem of a flower), the cerebellum, and the cortex (the large part). The lower structures develop first (brain stem), then the higher structures (cerebellum and cortex). When a baby is born, the brain is immature. The brainstem is the most mature, and regulates most of the baby’s functioning with almost automatic functions. This includes breathing, heart rate, and primitive reflexes. It’s like the baby’s functioning is on auto-pilot early on. As the baby learns about his or her environment and develops during the first year; the brain stem starts relinquishing more and more control to the other parts of the brain. Within the first year, the brain stem fully matures.
Movement!
The prefrontal cortex matures much later, not until a person is in their mid 20’s does it fully mature through movement and interaction with the environment. It’s also a use it or lose it type phenomenon; which makes it so important for children to receive information from the environment to their senses to react and move. This exchange of information creates changes in the brain and in the body systems. As your baby learns how to be in control of their bodies, the brain stem gives up some control to higher parts of your brain (cerebellum and cortex).
Think of your brain as a theater:
The upper level of the brain is the stage. You only notice what’s on stage during a performance; similar to your learning, planning, rational thinking.
The brain stem and cerebellum is like the backstage crew. Working behind the scene to make sure everything runs smoothly.
Primitive Reflexes
Develop in utero
Assist the birth process
Disappear (typically) within the first year, and replaced by adult reflexes
Are a test to the maturity of your central nervous system
Are strong, may interfere with development and function of the rest of the brain
Children have these reflexes for a reason, to help them through the birth canal and to help them adjust to a totally new environment (outside the womb). Reflexes are for survival until they learn to adjust. Unfortunately, they can interfere with development and function of the rest of the brain past a certain age.
We’ll go through each Primitive Reflex, starting with...
Moro
The Moro reflex is one of the more common, and have a large affect on child development. It has to do with when the baby or child loses head support, they go into fight-or-flight mode. This helps for the baby to take their first breath, protecting their airway, and alerts caregiver to a possible danger. The downfall to this is that if the stimulation to the nervous system continues upon the change in head position, releasing stress hormones, cortisol and adrenaline; it affects their arousal, sensory, immune and digestive system. With this adrenaline rush, it might present as that their really excited but that’s what happens when this reflex gets elicited. They might be at their stress limit more than usual due to this reflex that still persists. Result: This might be the child that has a hard time tuning out irrelevant information to continue their school work. They also may react more sensitively to auditory information.
Symptoms include: overreactive, hypersensitive, anxiety, hyperactive, visual-perceptual problems, poor impulse control, emotional immaturity, motion sickness, immune issues, stimulus bound, controlling behavior, dislike of changes.
Asymmetric Tonic Neck Reflex (ATNR)
This is a reflex that gets elicited when a child’s head turns right or left, and their limbs flex/extend in response. This reflex is for encouraging movement in the womb, assists with the birth, helps keep baby’s airway clear, early visual hand-eye training, and helps break up the two sides of the body. If not integrated, it makes it difficult for kids to coordinate both sides of the body, especially for reading and visual motor development.
Symptoms: poor balance and coordination, avoiding crossing midline, poor hand-eye coordination, difficulty with visual tracking, difficulty with reading and writing.
Tonic-Labyrinthine Reflex (TLR)
This is elicited when the neck is extended or flexed. This is another reflex that helps the baby get into a good position for birth, helps develop muscle tone, elicited by the vestibular system.
Symptoms: poor balance and coordination, visual perceptual problems, motion sickness, over or underdeveloped muscle tone, poor posture, toe walking, poor spatial skills, vestibular problems.
Spinal Galant Reflex
This is when a baby’s hips rotate towards stimulated side. It increases movement and flexibility in the womb, and promotes hip flexibility. As children get older with this retained reflex, sitting in a chair may be uncomfortable.
Symptoms: difficulty sitting still, hypersensitivity in the lumbar region (tags, waisbands), some connection to bedwetting.
Symmetric Tonic Neck Reflex (STNR)
STNR helps babies move from crawling on the floor to standing, spine alignment, and visual skills that allow them to focus on things close up and alternate to something far away. This might be the reason your child is uncomfortable sitting in a chair, needs to move in different positions to copy from the board, they may even sit on their feet. It may present as though they are students that don’t want to do their work, but it’s the difficulty they have with an immature postural system that is preventing them from sitting comfortably. This may also affect their attention and concentration, as well as hand-eye coordination.
Symptoms: helps the infant defy gravity (move from floor to standing), helps spine alignment, and visual accommodation (alternating visual focus for something close to something far).
Reasons for Retained Primitive Reflexes
This might be due to damage to higher levels of the brain, Pathology (Alzheimer’s and Parkinson’s), or maybe they never properly developed or withdrew during pregnancy, birth and infancy. In pediatrics, it’s usually the third case. This includes; complications with pregnancy, complications with labor and birth, or problems in infancy. It could also have to do with complications with pregnancy; medical problems, sickness, injury requiring bed rest, extreme stress, or alcohol/drug use. These are just risk factors, and it doesn’t mean that if one of these cases relates to your family- that your child will end up with a retained primitive reflex.
Treatment through Occupational Therapy
The way we treat a person with neurodevelopmental delay (retained primitive reflexes), is through movement and interaction with the environment. Special exercises are performed that stimulate the nervous system, and different parts of the brain stem. This is not a quick fix, it requires months of the program, but it is made manageable with the help of family and an Occupational Therapist to make an individualized and tailored treatment plan for your child’s needs.
Want to know more? Set up a free 30 minute consultation!
How Sign Language (ASL) Aids in Early Childhood Communication
This might sound either odd, or over ambitious for families to think about using sign language in their own household. Cue in a scene from Meet the Fockers with Little Jack signing a full sentence; Grandpa Jack wasn’t too far off...
So if there are no family members with hearing problems or people with communication disorders; why would you use it?
Did you know American Sign Language (ASL) is the third most studied language in the US? Outnumbered by only Spanish and French. So why would people use ASL? It’s something I’ve used in practice with children because even before a child can really start verbalizing, they want to communicate! There might be a misconception that if you teach your child sign language, they won’t be as motivated to verbalize or speak, or that it somehow hinders their speech development. Research says just about the opposite; and once kids develop speech, they’ll want to say it! ASL can help kids communicate sooner, possibly as soon as 6 months. Plus, it’s been shown that it can actually accelerate verbalizations and language by being able to put 2 words together sooner than children that didn’t use sign language.
It helps their basic understanding of language. ASL reinforces verbalizations and language by adding a visual cue with a kinesthetic movement to the auditory speech; targeting different senses for understanding and development of language. Signing also helps books become more interactive; kids thrive on learning through interaction, so when language comes to life (or signing) it makes it more interesting to kids. Babies have a natural tendency to use gestures and their hands, signing also reinforces motor development as they learn new skills.
For those in bilingual households, ASL can serve as a language bridge for children and adults who speak different languages.
Looking at the developmental milestones: at 6-7 months typically developing children start improving gross motor skills (bigger movements of the body), and sit independently. Somewhere between 10-14 months, the average baby says their first word. Signing builds upon those earlier developing gross/fine motor skills so that the baby can communicate before saying their first words. It also builds on a baby’s natural tendency to point and start to gesture with their hands to communicate.
Signing with Special Needs
For those with communication difficulties that continue through the years, sign language increases their opportunity to express themselves and connect with others. Some diagnoses that may benefit are Down Syndrome, Autism Spectrum Disorder, Cerebral Palsy, Expressive language difficulties like Aphasia/Apraxia, Learning Disabilities, Delays secondary to Premature birth, tracheomitized children, short term illnesses, Post-surgical conditions that inhibit speech.
OT Tips
Start with 3-5 signs at first. What do they need most?
Create the sign at the same time that you verbalize it.
Make eye contact, and create the sign as close to your face as possible.
REPETITION IS KEY. Exaggerated motions might also help, kids are drawn to movement and visual aids.
Be patient. Signing back may not happen for a while, it may take a few months.
Once they do sign back, celebrate! Confirm their accomplishment and encourage them to do it more.
It may not look perfect at first, accept approximations.
Let this become a part of your daily routine, to use in everyday context and their routines.
There are also some “made up” signs that might work for your family, which aren’t technically ASL signage, but will help your child communicate.
Whatever works for your family to help the little ones communicate, and hopefully reduce meltdowns. If you have any other questions, or you want to talk about your child’s development, contact us or schedule a free 30-minute consult!
Digital Diets and the Impact of Screen Time on Development
Let’s start with some statistics
In 2011, 38% of children, age eight and under used tablets and smartphones. In 2013, it went up to 72%. COVID-19 2020 could not have helped. In 2018, one-in-four children under the age of 6 had a smartphone. Use of mobile devices and children has risen from five minutes a day in 2011, to 48 minutes a day in 2017. Recent studies are revealing that kids and babies, under the age of two, are spending more than double the time in front of screens than they did in the 1990's. However, it’s not until around the age of 18 months that a baby's brain has developed to the point where the symbols on a screen begin to represent their equivalent in the real world. So what are they focusing on? Children under the age of two are wired to learn and remember things through experiences and by doing, but what researchers found is that children watching screens imitate 50% less actions than those children who engage in live three-dimensional interactions. Hindering their learning.
Let me give you an example of this hindrance - Baby Einstein videos have seven scene changes in just 20 seconds of video. So there's about one scene change every three seconds. What's actually keeping them engaged? The color changes and continuous changes in the screen! As a result; a real farm isn't keeping them engaged, and for every 30 minutes of screen time, there is a 49% increased risk of expressive speech delay. This statistic comes from a 2017 Canadian study by Dr. Catherine Birken, the first study that reports a link between handheld devices and expressive language delays. And now there are over 200 peer reviewed studies that point to screen time correlating to increased ADHD, addiction to screens, increased aggression, depression, anxiety, and even psychosis. The National Institute of Health is currently doing a $300 billion study using functional MRIs to examine the changes in brain structure among children who use smartphones and other screen devices. The first batch of results shows that kids who spend more than two hours a day on screens scored lower on language and thinking tests, kids who spend seven hours per day on electronic 5 devices show premature thinning of the cortex (underdevelopment).
Recommendation
From an OT’s perspective, I would recommend less than 2 hours a day 5 to 18 year olds, no more than one hour a day for children aged 2 to 5, and none for children younger than 18 months. Per day.
Research is showing us that children aged 3 to 5, whose parents read through electronic books, they had lower reading comprehension, compared to physical books because of all of the interactive features from electronic books that distract them from a focus on the actual story. Distractions, and being able to touch a feature of the visual representation is making it a different activity that doesn't involve as much learning required for reading comprehension, and word meaning. 80% of learning apps are targeted specifically towards young children, many claim to help children learn to read, but most don't.
Let’s take a look at some of the people that invented the tech
Most of the tech executives don’t allow children near certain devices. One specific school in the Bay Area where 75% of the parents are tech executives, do not allow any tech in the school. No iPads, no promethium boards, no whiteboards, no Chromebooks. Also, Silicon Valley nannies actually have to sign no technology agreements, meaning they won't be on a device and they won’t allow the children on a device while they're in their care.
It makes you take a step back to think about how these applications are made. Tech devices were made to keep people invested and entertained, not for learning. It’s recommended to use technology as a tool, not a toy.
There is much more details to go into so if you are curious and want to know more. Please feel free to reach out to me and book a free 30 minute consultation!
Take It Outside
Play is so important in Occupational Therapy Treatment, strong evidence supports play as a huge factor for health, development, and well being (Lester & Russell, 2010). We’re not just talking about playing on a soccer team, or participating in a group art class; we’re talking about intrinsically motivated play that’s child driven. It’s about how the child engages with others naturally and the experience of play as the driver of learning. It also shouldn’t stop at primary school.
Children today spend far less time outdoors than prior generations did. This is affecting children’s healthy sensory development, restricting movement opportunities.
Impacts of Less Play Time
Many teachers have reported decreased attention.
Posture is changing; Physical Therapists and Chiropractors are seeing preadolescent posturing with rounded curvature, and back problems. This may be due to different factors; limited core strength and back strength to keep body upright, kids are spending more time seated, which affects gait and posture, they’re also looking at screens more often.
Another thing teachers are reporting; kids falling out of chairs, clumsiness and bumping into other kids. Shedding light on possibly reduces body awareness and coordination.
Also, a rise in anxiety and depression.
There used to be more imaginative play, now it’s more structured, making it difficult to play outdoors, and access nature. Outdoor play is becoming more of a priority due to covid related limitations, and hopefully this opens new doors to making it more accessible for kids.
Why the Outdoors is Great
Nature is a great sensory experience; once you step outside, the wind is blowing, the sun, rain, or snow all stimulate different senses. Even reflecting on the ground; walking indoors is flat (predictable), outdoors the ground is uneven (unpredictable). Adjusting your body and how you process sensory stimulation is important for development. It allows for a calm but alert state for optimal organization of the sensory system. Even the environment is naturally calming; blue, green, brown in nature, which are scientifically proven to help feed at ease. Sounds typically played at a spa or are water, wind, things that calm us down. Some smells of trees will actually reduce cortisol levels in your brain, inducing calm. Being outdoors, constantly assessing your environment, creates a calming but alert state. Classrooms and clinics are typically filled with posters, many children in one place, and it may be disorganizing, this might provide some respite for children to learn. On average parents report 4-6 hours playing outside about 30 years ago, digging in dirt, playing with friends. Research shows that 48 mins is now the time for average outdoor play.
Biophysical Reactions to Play
Vestibular system: Research in the US says children sit 9 hours a day in a constant seated upright position (that’s Pre-pandemic). Children need to move frequently throughout the day to help move fluid in the inner ear, to stimulate the vestibular system; helping kids know their body in space. It makes them safer to have a well developed vestibular system. Climbing rocks or spinning shouldn’t be limited, it may reduce development and integration of the vestibular system. Behavioral optometrists support this; reporting movement helps with visual skills for reading and writing. It’s as if stimulation of the vestibular system turns the brain on for learning. Go upside down and climb trees, challenge the vestibular system to support activity regulation for learning in the classroom. Roll up and down the hills! Sledding! Mudslides! Tree climbing! Spinning/swings!
Proprioceptive system: This system is suffering for children when on devices. Resistance to joints and muscles are not being stimulated. This is how we develop understanding on how to hold a baby chick gently, use of appropriate pressure for writing, or playing tag without pushing too hard on other children. Shoveling, building dams, digging in dirt, carrying heavy buckets all give stimulation. Building fort is a favorite; kids love building a space for themselves.
Warning: This may not be natural at first. You may send your kids outside to play and the result may only be using the stick for digging, then coming back inside. But the next time they might realize they can write with the stick in dirt, and also use it for building a fort like they saw another kid did. This develops over time, but they may benefit from making it child driven, building on their ideas with increased creativity and using a different skill. Use the environment as inspiration, but allow the child to initiate play.
Additional Thoughts...
If a child relies on adults for ideas, it may result in not being an independent problem solver. Instead, allow the child to interact with others and get creative on their own for a more interactive play. Outside has a more full body engagement of the senses. Nature provides unpredictable sensory challenges to provide more learning and adaptability for changes in sensory experiences.
Children learn best through play; for social skills, emotional regulation. Child directed play allows for children to learn how to solve their own problems without help, and allows for socioemotional learning to build relationships. Let them dive deep into play; 20 minute recess doesn’t allow for it and there needs to be more opportunities for self-directed play.
Home Ideas: Promote outdoor play with setting up loose parts stones, tree cookies, bricks, fabric, logs, wood planks, gutters, pallets, baskets, egg crates, tires, dishware, tarps, buckets, junk in your basement, stainless steel bowls and plates, sleds, boxes, duct tape. How many parents have seen a child open a new toy, and play with the new box more? Let them be creative with a budget friendly option!
If you have additional questions or want to know more on how to implement more play, schedule a time for a free 30 minute consultation.
References:
Hanscom, A. (2016). Balanced and barefoot: How unrestricted outdoor play makes for strong, confident, and capable children. New Harbinger Publications, Inc.
Lester, S. and Russell, W. (2010). Children’s right to play: An examination of the importance of play in the lives of children worldwide. The Hague: Bernard van Leer Foundation
Mielonen, A., & Paterson, W. (2009). Developing literacy through play. Journal of Inquiry & Action in Education, 3 (1), 2009.
Savina, E. (2014). Does play promote self-regulation in children? Early Child Development and Care, 184:11, 1692-1705
Schunk, D. H. (1987). Peer models and children's behavioral change. Review of Educational Research, 57, 149-174. 3
The Therapeutic Benefits of Outdoor Play Recorded June 4, 2020 Presenter: Angela Hanscom, MOT, OTR/L OccupationalTherapy.com Course #4756
Primitive Reflexes - What Are They and How Long Do They Stick Around?
Humans are pretty amazing. We have been programmed since birth to react to external factors. For example, when there’s a bright light and you blink, your eyelids are acting involuntarily. This autonomic, innate response to environmental stimuli is a reflex behavior. They’re controlled by lower brain centers that are in charge of other involuntary processes, such as breathing and heart rate.
There are an estimated 27 major reflexes for infants! Typically present at birth or soon after birth (Gabbard, 1996). What Occupational Therapists call Primitive Reflexes, such as sucking and movement related for feeding early on, are related to instinctive needs for survival and protection. They also help with the early on connection to the caregiver. Some reflexes are related to human evolution; for example, the grasping reflex (child holding your finger tightly) which enables infant monkeys to hold on to their mothers’ fur.
Typically, these reflexes do not last too long. They may help with some necessary activities early on, but once we develop physically and cognitively to do things on our own, they’re not as needed. Higher brain centers become more active during the first 2-4 months, babies start to show postural reflexes; changes in position or balance. For example, babies who are tilted downward have a reflex to extend their arms in the “parachute reflex,” an instinctive way to break a fall. Some “locomotor reflexes” for walking and swimming are not present until months after the primitive reflexes disappear.
Most of the earlier reflexes disappear by the first 6-12 months. The reflexes that continue, like blinking, yawning, coughing, gagging, sneezing, shivering, and dilation of pupils in the dark, continue as protective functions. Disappearance of the unnecessary reflexes by a certain age is a sign that motor pathways have myelinated (developed), allowing your child to shift to voluntary behaviors. That is why Occupational Therapists can evaluate a baby’s neurological development by seeing if certain reflexes are present or absent.
If a child is having trouble with meeting certain developmental milestones, there may be some underlying cause for concern, as explained in the neurological development of your child. We are happy to talk to families about their child development, and help with occupational therapy if needed. Please schedule a FREE consultation to learn more!
Terrible twos? Or Astoundingly Autonomous?
Did you know that the “terrible twos” is not universal? In some developing countries, it’s viewed as “relatively smooth and harmonious (Mosier & Rogoff, 2003; Box 6-2).” It’s a well-known phrase that’s coming up more and more as I become close to starting a family. But, thinking back to my childhood; I’m not sure if it’s something my parents or family used growing up in an immigrant household. For good reason. In the United States, this stage is a normal sign for drive for autonomy. Toddlers are testing their limits as individuals, that they have control over the world, almost like new magical powers. It’s a trial and error of sorts, seeing how their ideas come into existence, making their own decisions. But this typically comes with the repercussions of a toddler yelling, “no!” Just for the sake of resisting authority. Almost all U.S. kids show some negativism to some degree, usually starting at age 2, peaking around 3.5/4 years old, and declining by about 6. If caregivers view this new found self-will as normal, and healthy for learning independence (not focusing on the stubbornness), it can help with teaching the child self-control and contributes to their sense of competence, avoiding excessive conflict. Easier said than done, but education and understanding of their development will help your child learn about themselves.
Here are some research based guidelines that can help parents of toddlers discourage negativism and encourage socially acceptable behavior:
Be Flexible. Learn the child's natural rhythm’s and special likes and dislikes
Think of yourself as a safe harbor. With safe limits, from which a child can set out and discover the world, to which your toddler can come back to for support.
Make your home child friendly
With unbreakable objects that are safe to explore.
Avoid physical punishment. It’s often ineffective, and may result in more damage.
Offer a choice
Even a limited choice can help, allow them some control. For example, “Would you like your bath now or after we read a book?”
Be consistent in enforcing necessary requests
Don't interrupt an activity unless absolutely necessary. Try to wait until the child's attention has shifted. If interruption is necessary, give warning. (“We have to go to the playground soon.”)
Suggest alternative activities when behavior becomes objectionable
For example, when a child is throwing sand in someone's face, say, “Look the swing is open!”
Suggest, don’t command
Accompany requests with smiles or hugs, not criticism, threats or physical restraint.
Link requests with pleasurable activities
(“It’s time to stop playing so that you can go to the store with me.”)
Remind the child of what you expect
For example, “when we go to the playground, we never go outside the gate.” Wait a few moments before repeating a request when a child doesn’t comply immediately.
Use a time-out to end conflicts
In a non-punitive way, remove either yourself or the child from a situation.
Expect less self-control during times of stress
(illness, divorce, the birth of a sibling, or a move to a new home).
Expect it to be harder for toddlers to comply with “do’s” than with “don’ts”
(“Clean up your room.” takes more effort than “Don’t write on furniture.”)
Keep the atmosphere as positive as possible
Make your child want to cooperate.
If you have any questions, book a free consultation with me and I will be happy to review with you!
Sources:
Haswell, Hock, & Wenar, 1981; Kochanska & Askan, 1995; Kopp, 1982; Kuczynski & Kochanska, 1995; Power & Chapieski 1986.
References:
Mosier, C.E., & Rogoff, B. (2003). Privileged treatment of toddlers: Cultural aspects of individual choice and responsibility. Developmental Psychology, 39, 1047-1060.