Factors for Fostering Competence in our Family
There may have been a time when we thought IQ, and level of intelligence was fixed at birth. But through research, we have learned that while there are inheritance factors, our experiences influence child cognitive development as well. This means parenting and guidance also influences how well our child does in school. So what specifically will stimulate our child’s brain to learn? And what characteristics of an early home environment increases measured intelligence?
The good news is… it’s easier than you think. For many parents, home schooling your child at the end of the school year brought on a new challenge, along with a pressure to become super parents turned teachers. But as you read some of the factors for increased child intelligence, it might seem manageable.
**In most of the research I’ll report on, it will reflect an assessment called the Home Observation for Measurement of the Environment (HOME), and neurological studies. Trained observers interviewed caregivers with a yes or no checklist relating to intellectual stimulation and support observed in a child’s home. HOME scores have found to be significantly correlated with measures of cognitive development in children.
Parental responsiveness is a big factor; the way we pay attention, caress, and kiss children play a part in their development. In a longitudinal study (data is collected on the same person/people over time), positive correlations were found between parental responsiveness to their 6 month old and the children’s IQ, achievement test scores, and teacher-rated classroom behavior through 13.
The number of books, play items that encourage development of concepts, and parent involvement in children’s play was assessed. An analysis of 29,264 children with the HOME assessments, learning stimulation (as listed above) were positively associated with kindergarten achievement scores, language competence, motor and social development.
*Note:
The HOME items might be less culturally relevant in non-Western than in Western families.
Also, we cannot be sure that the reason for correlational findings is based on parental responsiveness or an enriched home environment as responsible for increased child intelligence. We are able to find that these factors are associated with high intelligence. Intelligent, well-educated parents may be more likely to provide a positive/stimulating home environment, and because they also pass their genes, there may be a genetic influence as well.
Research is able to identify 7 specific factors of the early home environment to enable cognitive and psychosocial development, in order to help prepare for school.
Encouragement of Environmental Exploration
Mentoring on basic cognitive and social skills
Celebrating your child’s developmental advances
Guidance in practicing skills, and building on them
Protection from inappropriate disapproval, teasing or punishment
Communicating well, and responsively
A balance between guidance, and limitations of behavior
These conditions are generally linked to many areas of brain functioning and cognitive development. Some of you may read this and feel like you already have these factors in your household. What it boils down to is - being present in guiding and playing with your child is one of the most important things you can do for them. Even with all the stress and expectations you may have for yourself or your spouse, remember to prioritize communication, guidance through things they might not understand, and play! Whatever play skills are important to your child will encourage skill development, and support when needed.
To learn more, please feel free to email me at smplytherapy@gmail.com. I look forward to hearing from you!
The Importance of Play
Board games… It’s an essential for any Occupational Therapy Clinic, and might be found in your house. Board games are essential for learning without a syllabus. As we approach the unknown with how our upcoming school year will be, we can encourage good habits that keep our children engaged and learning in a manageable way. As I watch all the children of my family clutching to their iPads, board games may sound a little old fashioned, but you may be surprised to see how much fun they have with it! It’ll probably bring back some childhood memories for you as well!
Recently, I’ve been spending more time indoors with family due to the quarantine, and it’s hard to get creative at times. That’s what I love about board games, there’s enough color and entertainment that keeps kids occupied and off the tablets. I’ll go through three classic board games and tell you how to adapt for certain ages and to adapt for age gaps between kids. Most games have the age appropriate label, which is a good indicator, you can adapt for younger ages at times with different techniques.
Scrabble
The age listed for this game is 8+, but children start learning to spell around 6 years old. This game is especially helpful to support that learning especially if an adult is present they can give cues or assist for the child to participate. Kids as young as 3-4 can help a parent put the words on the board for them by directing the child to put cued letters on the appropriate spaces. That could help the young ones with following one step tasks and fine motor skills. For the older kids, it would work on spelling, literacy and critical thinking to get the most points. Also, for younger kids (6+), you can cue them to do simple math to figure out the word scores. The great thing about scrabble is that you can play with 2-4 players, so even if it’s an only child household, they can participate with a parent.
Monopoly
The age listed for this is 8+ as well, but it can be adapted many ways for younger kiddos. This past weekend I was playing with my 5 year old nephew, the family included him in the game by letting him sort the money, and hand the money to the banker for players. It may be a small part, but it’s participation nonetheless! So for the babies of the family, they can help with sorting money by color, throwing dice, and helping with placement of the figurine on the appropriate box (with pointing and coaching from an adult/older child). This game does involve a good deal of reading and critical thinking for those that are older, and as most of us know- it can go on, and on. It also comes with learning some of the frustrations of pretty real-life stresses. Paying rent, having to pay taxes every (year) round, and critical thinking for how you’ll get ahead. If you’re playing with an older child above 8, I recommend making them the banker so that it challenges them a little more with math skills.
Connect Four
This is a classic that I’ve used in practice with ALL ages. I’m talking about 2 year olds to 100 year olds. It’s easy to set up, there are different ways of using it, and it’s strategic for older people, but simple enough for kids as well. For the young ones, at about 12-15 months kids can pick up the discs and use explorative play. By about 2 years old, kids can start picking up the discs and place them into slots as a game. At about 18 months, they can do it by color. As for kids that are younger than about 7, they will be able to imitate or copy an adults strategy for playing Connect Four, but according to Piaget (a developmental psychologist) - those skills to understand rules, apply them, and using logic does not develop until about 7. These skills are important once they get to that age, to encourage games like this. But before then, they will need coaching and explanations for different game tasks.
Quick Understanding of Play Development:
Exploratory Play (0-2 years old) - Exactly how it sounds, they explore the properties and effects of actions an objects and people, usually mostly with parents/caregivers
Symbolic Play (2-4 years old) - Experiences where the child formulates, tests, classifies and tweaks ideas, feelings, and actions. Associated with language development, not exactly playing with children just yet, becoming more cooperative over time.
Creative Play (4-7 years old) - This is when children start to cooperate in peer groups, they explore actions on multiple objects. They start to refine skills in play experiences with sensory, motor, cognitive, and social play.
Games (7-12 years old) - This is when games with rules really come into play. Social interaction, competition are big in this stage, as well as making friends as a validation of play items and performance.
Medicate or Not?
As pediatric practitioners, we often hear about medication and ways to help with symptoms for psychiatric diagnoses, in combination with our treatment. But how safe is medication? Do they have an affect on their health? As a focus of a previous blog, we looked into the prevalence and symptoms of ADHD…
“Symptoms are often noticed during the early childhood years before 3 years of age. However, caution is advised on early diagnosis and will most often be made during elementary school years when behavior is interfering with school performance. Some other notes on symptoms:
Occurs in 5%-8% of elementary school aged children.
Prevalence in boys to girls is a 3:1 ratio, most common in first born boys.
Partial remission may occur in ages 12-20. Hyperactivity may disappear during these years to allow for a productive adolescence but distractibility and impulsivity can persist.
Symptoms persist into adulthood in 60% of cases.”
In reference to treatment of something like ADHD, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Behavior Disorder, there are usually a combination of treatments. Behavioral techniques, and medications. But most importantly, before your doctor gives you a script for a prescribed medication- there should be a thorough process to make sure that your child is diagnosed appropriately.
It’s true, that medication for ADHD can be overused, but the under-diagnosed and under-treated factor for ADHD is more often than over treatment. Your child should not be diagnosed as having ADHD after a 10 minute exam. There should be behavior reports from multiple sources, surveys, medical history, and a clinical interview with your child.
After a thorough evaluation, you can discuss options with your doctor. The most common medication is Methylphenidate (Ritalin, Concerta, Metadate, Daytrana, Quillivant), and has been used for over 50 years for symptom management of inattention, impulsivity, and hyperactivity. If symptoms are affecting your child's quality of life and learning, it’s something to consider with the supervision of your doctor. Side effects seem to be not life threatening according to research, there may be problems with sleeping, or decreased appetite, but you can always discuss adjusting the dosing with your doctor to get a better fit.
Other treatment options:
Occupational Therapy is one of the specialized treatments that can help your child perform in school and at home. When I treat in schools, there were often times that I would go into the classroom with the child to help learn different coping strategies and techniques to facilitate his or her attention. We also took time to educate the teacher on the strategies we were working on in order to facilitate learning. Also, as an occupational therapist I encourage participation in functional activities and extracurricular activities (at their pace), to help with time management, organizational skills, positive social interaction, and an outlet to feel successful in.
References:
https://www.bmj.com/content/351/bmj.h5203
https://www.health.harvard.edu/blog/adhd-medication-for-kids-is-it-safe-does-it-help-201603049235
What Affects Children’s Memory for Learning?
Pretty recently, I saw a post on Instagram saying something along these lines…
Kids Remember:
10% of what they read
20% of what they hear
30% of what they see
70% of what they say & write
90% of what they do
Which is great visually, it makes you consider how important learning by doing would be in comparison to reading. But the neuroscientist in me made me question all the even numbers. As much as I’d love to see a list of numbers rounded to the tenth degree, it almost never happens when we’re reading research. It also made me consider my experience as an OT, and other kiddos in treatment that learn differently. I have read research that states people who are using different sensory systems to learn a new task or skill, have a better chance at retaining it. But, I couldn’t help but question where that statement derives from.
Here’s what I found…
There was an educational theorist named Edgar Dale in the 1960’s who developed a theory that “learning by doing” allows for individuals to learn better as opposed to hearing, seeing or reading information (See Table Below). This has become known today as “experiential learning” or “action learning”. As much as the premise of his theory may hold true, the numbers don’t seem to play out accurately in research.
Here’s what we do know about kids learning patterns (based on research):
Everyone Learns differently. The way the brain stores information may be similar, but the efficiency and the way we process things as individuals vary.
Read with your child! The earlier the better, it has proven to support emotional well being, speech, reading (themselves), empathy towards others. Even having children read with caregivers helps children feel closer to their parents.
The more familiar children are with an item, the better their memory is on it. This emphasizes the importance of exposure to different environments/topics for learning.
Young children often forget the strategies for memory strategies, and need someone to remind them. Giving credit to the coaches in our families.
Preschoolers tend to remember things they did better than things they saw. Supporting Montessori style of Education.
One research study showed that children ages 2.5-3.5 whose mothers used highly elaborative techniques in conversation when talking to their children, recalled more detailed memories than those that did not. Mothers also tended to speak to girls with more elaborative techniques than boys, which may explain why women tend to have more detailed and vivid memories from an early age than men.
***Highly elaborative language techniques include; asking a child a question that elicits more information. For example, After asking a child “Do you remember how we traveled to Florida?” receiving an answer, “No,” from the child then asking “Did we go by car or plane?”
A low elaborative language technique would follow up with (repetition) “How did we get there? We went in the _____.”
Bilingual children tend to have better attentional control, which may enable them to focus on what is true rather than on what only seems to be so.
To see a visual of the E. Dale, Audiovisual Methods in Teaching, click here
To learn more, please feel free to reach out to me at smplytherapy@gmail.com.
Resources:
Subramony, D., Molenda, M., Betrus, A., and Thalheimer, W. (2014). The Mythical Retention Chart and the Corruption of Dale’s Cone of Experience. Educational Technology, Nov/Dec 2014, 54(6), 6-16.
Subramony, D., Molenda, M., Betrus, A., and Thalheimer, W. (2014). Previous Attempts to Debunk the Mythical Retention Chart and Corrupted Dale’s Cone. Educational Technology, Nov/Dec 2014, 54(6), 17-21.
Subramony, D., Molenda, M., Betrus, A., and Thalheimer, W. (2014). The Good, the Bad, and the Ugly: A Bibliographic Essay on the Corrupted Cone. Educational Technology, Nov/Dec 2014, 54(6), 22-31.
Subramony, D., Molenda, M., Betrus, A., and Thalheimer, W. (2014). Timeline of the Mythical Retention Chart and Corrupted Dale’s Cone. Educational Technology, Nov/Dec 2014, 54(6), 31-24.
Practicing Taking a Break
We’re all looking for creative ways to take a mental break. As we’re in the middle of a more restricted summer, with limitations for kids to join summer camps, restrictions for traveling, parents may find it hard to have some time to themselves. Here are some ideas for the adults to take a mental break
Communicate with your partner/spouse and/or family/caregivers. Talk about different ways you can alternate taking an hour or two to yourself. I know it’s a hectic time for families, but sometimes even taking a walk in the morning for 30 minutes while one parent stays at the house with the kids can be enough to fill your emotional cup. It may not even be daily. Things can come up, but set out a little time for yourself to be able to focus on your mental health.
Gardening
It may seem like something that’s not too motivating, but the sensory experience you get from gardening has been shown to reduce stress. It’s a relaxing time to focus on one task without technology, before shutting it down, try it out for yourself!
A study found that people who garden for 30 mins are found to be in a better mood than those that read for 30 mins. The gardeners also have lower amounts of the stress hormone cortisol. Another study found that participants with Depression, Bipolar II disorder and persistent low moods experienced improved symptoms after 3 months of just gardening 6 hours a week. Also, there’s a harmless bacteria found in soil - Mycobacterium vaccae, which have been found to increase the release and metabolism of serotonin in parts of the brain responsible for mood and cognitive function in mice.
Gardening is a good exercise, it has been shown to reduce your risk of developing Dementia. If you want to be interactive with your kids, it also allows you to teach your child to understand where their food comes from. This fosters a better diet by becoming more involved with different healthy foods. You don’t have to have a large backyard. You can even start small like me- with a few pots of herbs in your apartment.
Mindfulness
It might be a topic that many people brush off, I know I did when I was introduced to it in college. I vaguely remember a man coming into my OT school, he was talking about being more aware of your thoughts and did some mindful exercises. We all participated, but it didn’t stick until later in life... about 8 years later.
I can’t convince anyone to do something that they don’t believe in, just as the presentation didn’t do me a great deal of justice for me as a college kid. But I hope to help people understand new ways of dealing with stress, especially during this time of need. A 2014 study said people would rather get electric shocks to themselves than be alone with their thoughts. Another study shows that most people have a hard time focusing on the present, resulting in stress. I’m not sure about you, but it seems pretty relatable to me. Very few conversations avoid the talk about what’s to come with COVID-19, how the schools will operate, or how our lives are going to look in 3 months. That takes a toll on us, mentally.
Stress can do more than affect our mood, research shows that 8 out of 10 Americans experience stress daily, have difficulty relaxing or calming their minds, which results in high risk of heart disease, stroke and other illnesses. Mindfulness techniques are used by schools, prisons, sports teams, and the U.S. Army to help counter stress, chronic pain, and other conditions. It’s a secular practice that reduces stress and anxiety, improves attention and memory, and promotes self-regulation and empathy. Studies have also shown that mindfulness meditation can change the brain’s gray matter and brain regions responsible for memory, the sense of self, and regulation of emotions.
Here’s a beginner’s guide from The Harvard Gazette:
Settle in: Find a quiet space. Using a cushion or chair, sit up straight but not stiff; allow your head and shoulders to rest comfortably; place your hands on the tops of your legs with upper arms at your side.
Now breathe: Close your eyes, take a deep breath, and relax. Feel the fall and rise of your chest and the expansion and contraction of your belly. With each breath notice the coolness as it enters and the warmth as it exits. Don't control the breath but follow its natural flow.
Stay focused: Thoughts will try to pull your attention away from the breath. Notice them, but don't pass judgment. Gently return your focus to your breath. Some people count their breaths as a way to stay focused.
Take 10: A daily practice will provide the most benefits. It can be 10 minutes per day, however, 20 minutes twice a day is often recommended for maximum benefit.
References
Wilson, T. D., Reinhard, D. A., Westgate, E. C., Gilbert, D. T., Ellerbeck, N., Hahn, C., Brown, C. L., & Shaked, A. (2014). Social psychology. Just think: the challenges of the disengaged mind. Science (New York, N.Y.), 345(6192), 75–77. https://doi.org/10.1126/science.1250830
Killingsworth MA, Gilbert DT. A wandering mind is an unhappy mind. Science. 2010;330(6006):932. doi:10.1126/science.1192439
https://www.wbur.org/commonhealth/2018/04/06/harvard-study-relax-genes
https://www.sciencedirect.com/science/article/abs/pii/S092549271000288X
http://www.cnn.com/2011/HEALTH/07/08/why.gardening.good/index.html
A Video Game for ADHD?
After hearing about a new FDA approved prescription video game for ADHD, I had to read the research myself to believe it. At first thought, it seemed counterproductive to me. How can something that typically has been known to be a distractor help ADHD? Don’t get me wrong, technology has its pros, such as increased productivity for the workplace, convenience of shopping from home, even working from home thanks to COVID but it still makes me question the effectiveness of a video game to improve your attention.
In today’s day and age, technology is such a large part of our lives. Screen time on our phones increase, and our threshold for the amount of “multitasking” for the first hour of our work day has drastically increased over the past 20 years. Below is part of the research study that I found. I hope you find this useful!
ADHD is a widely known diagnosis that children struggle with, it accounts for about 5% of US children, and is the most commonly diagnosed pediatric mental health disorder. As we learn more about mental health in the US, we want to find the safest treatment - especially for children who are still developing and growing. Medication has it’s side-effects, and has short-term efficacy. I was especially surprised to hear that the trials used for pharmacological efficacy for ADHD typically used parent rated or clinician rated symptom measures! This means the research to back these drugs used for ADHD are mostly based on the parent or clinicians subjective opinion. Having alternate methods outside of pharmacological intervention is important, especially if it has limited improvements that become outweighed by side effects.
Participants: 8-12 years old with ADHD, No Medication even if regularly taken, 348 kids
About the Study Design: Randomized, Double-Blind, Parallel-group, Controlled Trial
The video game trial would be an alternative method that would be engaging, but also reduces adverse effects (negative side effects). The novel digital therapeutic. AKL-T01 (Akili Interactive Labs, Boston, MA, USA), was made to engage children with ADHD but also targets attentional control to improve completion of tasks and shift attention more efficiently between tasks. What makes this trial unique to research for the ADHD population, is that it uses objective cognitive assessments to measure outcomes. So, findings are not based on a parent or clinician opinion of the results, but tests administered to the child. The trial showed significant improvement in attention-related measures with children that used the video game AKL-T01, compared to the group that did not. It also reduces negative side effects for the child. The only reported adverse effects included 7% of children using AKL-T01 were frustration and headache, versus 40-60% of children in trials of commonly used stimulant medications (which has a lengthy list depending on the medication). Specifically, trials done for stimulant medications don't have research on the functional improvement on a validated measure that this study has. There definitely needs more research done to see the long term effects of this video game, but it’s a novel treatment technique that may be safer and more accessible to families in the future.
References
Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol 2014; 43: 434–42.
Catalá-López F, Hutton B, Núñez-Beltrán A, et al. The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: a systematic review with network meta-analyses of randomised trials. PLoS One 2017; 12: e0180355.
Cortese S, Adamo N, Del Giovane C, et al. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry 2018; 5: 727–38.
Shams TA, Foussias G, Zawadzki JA, et al. The effects of video games on cognition and brain structure: potential implications for neuropsychiatric disorders. Curr Psychiatry Rep 2015; 17: 71.
Kollins SH. Moving beyond symptom remission to optimize long-term treatment of attention-deficit/hyperactivity disorder. JAMA Pediatr 2018; 172: 901–02.
Kollins SH, DeLoss DJ, et al. A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomized controlled trial. Lancet Digital Health 2020: Volume 2, Issue 4, E168-e178.
Wolraich ML, Greenhill LL, Pelham W, et al. Randomized, controlled trial of oros methylphenidate once a day in children with attention-deficit/hyperactivity disorder. Pediatrics 2001; 108: 883–92.
What is Sensory Processing?
What is Sensory Processing?
It's a normal brain function that allows us to take in a wide variety of information and transform it into an adaptive response.
5 senses, or 8?
There's Auditory, Olfactory (smell), Gustatory (taste), Tactile (touch), and Vision. But there's also Vestibular, Proprioception, and Interoception.
What are the last 3?
The Vestibular system receptors are in the inner ear, it influences balance and movement
The Proprioceptive system receptors are located in muscles and joints to know where your body is in space (minus vision)
Interoception is emotional self-awareness
How does this affect behavior?
Sensory Processing is crucial to discuss when evaluating a child as the vestibular, proprioceptive, and tactile systems develop in utero and along with sound and vision, lay the foundation for all the other skills to develop.
For Example: When a child is learning to ride a bike.
The vestibular system assists: balancing his body on the bike in midline
Proprioception: to position himself properly, keeping their feet on the pedals and chest upright
Vision: for navigation, and following the bike path
Hearing: for safety of other bike riders or something in motion that can collide
The senses must accurately and quickly detect any imbalance. After a few falls and learning how to coordinate movement, their sensory processing for weight shifting becomes more accurate.
*Fun Fact: There are blind people that are fully capable of riding a bike with increased sensory processing of the other senses, check out the podcast Invisibilia- How to Become Batman.
Sensory Processing difficulty signs:
Without reliable information about body position clumsy, distracted or awkward
Using too much or too little force for writing, clapping, marching or typing
Picky Eating/sensitivities to food textures, may cause gagging
Handwriting Difficulties
Excessive fear during ordinary movement activities
Difficulty with certain textures of clothing
Fear of swings, or reacts poorly to sudden movements/touches/noises/bright lights
Behavior problems
Can’t sit still
Thrill seeking
Doesn’t recognize personal space
Chewing on things
Doesn’t recognize when face is dirty or nose is running
Problems sleeping
Treatment:
Coping strategies and highly customized sessions with an Occupational Therapist is typically the treatment for SPD. Treatment addresses their sensory needs and introduces stimuli without making your child feel overwhelmed. This will help your child cope, and learn how to deal with adverse stimuli in everyday life more independently and with less trouble.
If you have more questions, please email me at smplytherapy@gmail.com or schedule a free consultation with me here.
Fun Activities for Kids This Summer (During a Pandemic)
We can almost see the light at the end of the tunnel! School’s coming to an end and parent’s are planning for the summer ahead. But how safe is it for children to enjoy the parks opening back up, and how will parents adjust their usual summer plans to make sure their family is safe? There are options for virtual camps and classes that have been a way for small businesses and community programs to stay running. However, this leads us to asking, how can I keep my child safe?
Here’s what we know:
COVID-19 can live up to 72 hours on a plastic and stainless steel surface (Source: New England Journal of Medicine)
The amount of virus living on that surface that would result in contracting the virus is limited.
What we suggest:
Social distancing as a precaution, limiting games or play activities that require close physical contact.
Face Masks for children that are above the age of 2 (refer to blog below on helping children with face mask use)
To help children clean dirt on hands, rinse hands with water, then proceed to use the hand sanitizer
Watch for any signs of COVID-19 symptoms. This can look different from person to person. While most infected people have not gotten very sick, watch out for flu-like symptoms (Source: CDC).
Make preventative actions a habit. Wash hands! Parents are the role models of the house and children typically model parent behavior, so it’s suggested for parents to wash hands, and to make it a family activity.
Stay active! Doing activities will help boost physical and mental health (Source: CDC). Go for walks, bike, or visit a park for outdoor exposure. Indoor activities may include stretching, dancing, or even some gross motor activity games.
Here are some of my favorite Activities:
Board games in prone position (laying on their stomach)
Twister for Proprioceptive input to help regulate your child
Animal Walk races (bear crawls, crab walks, and bunny hops)
Jenga to work on Fine Motor Skills and Motor Planning
Break the Ice for a Fine Motor Activity
Arts & Crafts this allows your child to get creative
Baking/Cooking activities- Depending on your child’s age, you can use this activity to help with reading and following directions
You can even make puzzles more dynamic with a treasure hunt to find the pieces.
Try a new sport now that parks are opening back up- frisbee and soccer are some of my favorites with kids
Build a fort with all those delivery boxes from quarantine
Take a look at Free virtual events for parents and kids, click here to register for our free event next week!
Yoga for kids videos online
Virtual game night via House Party to get friends and family together
Gardening is a fun way for kids to learn how their food is grown and gives great sensory input for regulation
Stay socially connected. Loneliness has a huge effect on immunity and mental health, so keeping those little ones connected with social distancing guidelines are important (Cole, S.W., Hawkley, L.C., Arevalo, J.M. et al., 2007). Use video chats to create virtual playtime, phone calls, cards, letters; any way to make your child feel connected. Check your local school districts for tips and guidelines, community facebook groups, and local libraries. Social media has also been a huge help in the effort for communities to come together, Instagram, Facebook, Twitter, to see what's happening in your area.
Be aware of signs of extreme stress or change in child behavior. This goes for all of us, but especially the little ones of the house may not have developed the introspection, or awareness of how they are feeling. Signs include, excessive worry or sadness, unhealthy eating or sleep habits, or difficulty with attention/concentration.
If you have seen an extreme change in your child’s behavior, talk to your doctor. If you have any questions, or think your child may benefit from our Occupational Therapy Services, please follow this link for a Free Consultation with Smply Therapy.
Here are some resources from the CDC to help you and your family
https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/for-parents.html
https://www.cdc.gov/coronavirus/2019-ncov/about/share-facts-h.pdf
https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/talking-with-children.html
https://genomebiology.biomedcentral.com/articles/10.1186/gb-2007-8-9-r189
To register for our free Virtual Wellness Event:
https://success-street.webinarninja.com/live-webinars/354632/register
How to Talk to Your Kids About Race
If the past few weeks have brought anything to light, it’s that racial inequality is still very much alive and it is so important to address this seemingly uncomfortable issue in our homes. As a Hispanic American who was raised by immigrants, it is my natural instinct to identify with the minority population with great empathy, but I say this with the understanding that I do not know what it is like to be Black in America. Even in my experience as an Occupational Therapist, caring for people of all ages, I can reflect back on experiences where there were patients demanding a different healthcare practitioner based on race. Specifically because of their black skin. It was a part of my job then, as it is now - to help educate those who do not understand the importance of the Black Lives Matter movement, and racial injustice. There are disparities between all different types of racial groups, and every group has their own fight, but right now we need to focus on this movement, to raise awareness and support for Black Lives.
The inequalities are systemic resulting in mass incarceration, housing discrimination, lack of access to healthcare, high poverty rate, education disparities, and barriers to unemployment. These in turn are some of the reasons for why black and brown Americans are the highest risk for Covid-19 and the devastating effects of Covid-19.
The first step is having a conversation within your household, in our schools and early education. Racial injustice did not start in one day, and it won’t end in one day. But we have the benefit of leveraging social media platforms, increased community involvement, and increased education about racial injustice. It makes me proud to see the way people are teaming up and being supportive and I want us all to keep the foot on the accelerator for change.
Here are some tips and guidelines for teaching the future of our country, aka our children…
NO, it’s not too early for education.
Up until 3 months, children look at all races equally. Starting at 3 months, our children look more at faces that resemble their caregivers. Why is this important? It’s not that there is any ill-natured intention at this age, but we already start to associate race with meaning. In this case, comfort and familiarity. At 2 years old, children start to associate behavior with race.
*Psych Note*
It is a natural instinct for us to want to understand things as quickly as possible. Part of the way we process memory is called Categorization. It’s an important mental act that allows us to not confuse a red billiard ball to a red apple, or an alley cat to a dachshund. They may be similar size and shape, but we are able to differentiate so quickly we might classify it as common sense (Mlodinow, 2012).
On the same note, as humans, we would like to polarize our categories. If we identify one trait as belonging to a category, we associate a strong similarity to that one specific group. Our unconscious turns subtle differences to clear distinctions as a form of cutting out the fluff to see things clearer. Clearer than if we were looking at those fuzzy differences with objective data. Done inappropriately, and we have distorted representations of categories. This is especially true when we look at race, without the understanding and education on race. It is the basis of racial injustice, and the unfortunate root of systemic racism. Our subconscious wants to believe that doctors at one workplace, fans of a specific team, and individuals of a certain race are more similar than in truth.
Ways we can teach our kiddos…
Talk about race, and continue the conversation. As long as you make it an effort to talk about it, it will be a step in the right direction.
Storytelling with toys, get creative!
Model inclusive behavior
Broaden our children's books to talk about races that not only reflect that of their culture, but those of others as well.
Diversify the skin color of your children’s doll collection (if applicable)
Education through media- there is a revolutionary happening for the film and production companies as well, to represent different stories. Take advantage!
Below are some social stories to address race and protesting
Social Stories from Autism Little Learners:
https://drive.google.com/file/d/14YoVmLcOQPbgaWY3eposALmP95GDBrhF/view
https://drive.google.com/file/d/1vRACFpkcGYZZJJLuI351wkJ2RPn0AuzK/view
This is in dedication for racial injustice to the families of George Floyd, Eric Garner, Breonna Taylor, Amaud Arbery, Tony McDade, Botham Jean, Atatiana Jefferson, Stephen Clark, Philando Castille, Trayvon Martin, Michael Brown, Tamir Rice, Jonathan Farrel, Renisha Mcbride, Jordan Edwards, Jordan Davis, Aiyana Jones, The Charleston 9, Sean Bell, Oscar Grant, Sandra Bland, Corey Jones, John Crawford, Terrence Crutcher, Clifford Glover, Claude Reese, Randy Evans, Yvonne Smallwood, Amadou Diallo, Walter Scott, Freddie Gray, the list goes on...
Donate:
NationalBailOut.org
MutualAid.org
BlackVisionsmn.org
ReclaimTheBlock.org
MinnesotaFreedomFund.org
GoFundMe.com/f/georgefloyd
https://www.aclum.org/en/publications/data-show-covid-19-hitting-essential-workers-and-people-color-hardest
You Are What You Eat - Or Are You?
Most of us have heard the term, “You are what you eat.” Or craving certain foods, usually carbs while in quarantine. Diet has a huge effect on your well-being and quality of life and there is a reason why we might be craving a bagel (daily).
There has been research on certain foods to help us understand and balance our diet that could be beneficial for you and your family. Especially those with children, parents will do anything to help their child get proper nutrition.
We’ll start with, “Sugar High” Debunked
Wouldn’t it be easier to blame a behavior on a specific food? To know what may be causing certain behaviors, and have better control or at least prediction of how your child will feel. Especially those with children with diagnoses as ADHD, to better manage symptoms. It’s a myth that has gone around but has been proven to have no effect on children's behavior unfortunately. Research conducted included 94 thorough studies testing normal Preschool children whose parents described them as “children with sensitivity to sugar.” In this study, some children were given items with sugar, and others with diet substitutes or sweetened with aspartame/artificial sweeteners. The children were then given 9 cognitive and behavioral measures. The parents, nor the children or researchers knew who got which items to make the study valid. It was found that sugar does not affect kids behavior or cognition.
Though sugar does not affect children’s behavior, it is still recommended to reduce sugar intake to reduce risk of obesity, Type 2 Diabetes, and heart disease.
Food nutrients, and timing of meals are correlated with mood and behavior. Research indicates that high protein and low carb diets may assist in increasing concentration and alertness. Nutrients may also be a therapeutic agent for reducing symptoms of Depression, Insomnia, Hyperactivity, Chronic Pain. Neuroendocrinologist at MIT Dr. Richard J Wurtman reports “It's likely that early in life people make associations between the consumption of certain foods and changes in how they feel... then, later on, they unconsciously turn to those foods to recreate the desired feelings.” Thus eliciting an emotional response when it’s seeked. Carbohydrates for example will typically give us a feeling of relaxation or calmness due to the increase in level of serotonin in your brain. If only getting a runner's high was as easy as taking a bite of a donut, we’d all be marathoners.
It’s something to consider, especially in this time of quarantine and isolation. We may find ourselves seeking comfort in what is safe, which is food. Unfortunately, the odds (or increase in serotonin) are not in our favor when it comes to dieting with low carb and high protein, ''These diets induce a serotonin deficiency in the brain which in turn could trigger carbohydrate cravings to correct the imbalance,'' says Dr. Wurtman.
Food/nutrients are the precursors for neurotransmitters to send signals to the brain. That facilitates mood and behavior. Tryptophan, an amino acid, raises sleep promoting serotonin and melatonin. Anyone else need to nap after that (Tryptophan filled) turkey at thanksgiving? So tryptophan contained meats and fishes may be able to treat mild sleep insomnia without mood effects or central-nervous-system depression. Tryptophan can also help with sensitivity to pain without side effects as reported by Dr. Dorothy Dewart.
Children with high consumption of caffeine however did report with more hyperactivity, frustration/anger than children with less intake. It was found that sugar actually had a calming effect on children studied by Dr. Rapaport, which reflects our findings of carbohydrates. Also, some may not feel the effects of coffee in the morning because the stimulation is combined with the effects of a roll or bread in the morning with the opposite effect. It’s also suggested that nutrients eaten on an empty stomach have more of an effect on mood and behavior. But eating breakfast nonetheless would help a child's performance in school, especially if it’s high in protein.
Sources:
https://www.nytimes.com/2020/02/21/well/eat/is-there-such-a-thing-as-a-sugar-high.html
https://jamanetwork.com/journals/jamapediatrics/article-abstract/1173788
https://pubmed.ncbi.nlm.nih.gov/669509/?from_single_result=669509&expanded_search_query=669509
https://pubmed.ncbi.nlm.nih.gov/8277950/?from_single_result=8277950&expanded_search_query=8277950
https://pubmed.ncbi.nlm.nih.gov/8277958/?from_single_result=8277958&expanded_search_query=8277958
Hoyland, A., Dye, L., & Lawton, C. (2009). A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutrition Research Reviews, 22(2), 220-243. doi:10.1017/S0954422409990175
Bourre JM. Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging. 2006;10(5):377‐385.
Entering Our New "Normal" - After COVID
As shelter-at-home comes to an end and all 50 states are finding ways to open up, we’re facing a new “normal” that will take some getting used to.
New York is currently not opening back up just yet, we’re hearing of possibly opening back up in June, the wait continues. New Jersey has decided to start opening back up in small increments starting with Parks and Golf courses for passive recreation (fishing, hunting, boating, canoeing, hiking, walking, running or jogging, biking, birding, and horseback riding). Picnic areas, playgrounds, exercise stations and equipment, chartered watercraft services and rentals, swimming, pavilions, restrooms, and other buildings and facilities, such as visitor centers, interpretive centers, and interior historical sites remain closed. This past Monday, NJ also started opening non-essential businesses for curbside pick-up, moving into stage two with expanded retail, outdoor dining, indoor dining at reduced capacity, limited personal care and possibly museums and libraries. NY Counties north of the city are starting to do the same. With this new phase comes some concern with how to go about this safely, especially those with little ones, or older adults.
Some quick basic info (CDC):
The virus spreads person to person in close contact, typically within 6 feet contact secondary to Respiratory Droplets. Meaning, via cough or sneezing.
My blogs report scientific based data that has been backed up by research or trustworthy associations. What I find important is to educate the public on not only understanding the nature of the virus, but also to reduce anxiety about how to deal with this re-entering phase.
Our immune systems are built on introducing our bodies to germs and bacteria. Without doing so, we reduce our abilities to fight infection. The take-away from this is, (some) germs are good! The quarantine has reduced our immune system to come in contact and fight germs/illness, so small increments of going for walks and slowly increasing exposure is best for those without symptoms. Of course, if you are sick or have symptoms please stay home and take precaution. But fear and anxiety will be one of the biggest barriers to living healthy lives post-covid.
To help with anxiety- breathing exercises, yoga, and meditation are great outlets. Many small businesses are offering virtual classes, including Smply Therapy in the near future! Also, Peloton, and CycFitness has been offering free packages on their app for a short period of time.
As we open up, the CDC recommends:
Facial Coverings are necessary for entering stores and places where there will be close contact to other people because you don’t know someone elses pre-existing conditions that may make them at increased risk for respiratory distress if infected.
It is always recommended for you to wash hands for 20 seconds. I’ve worked in hospitals and rehab settings that require training on hand washing, so this is always a precaution for caring for your community, and those members that have chronic illnesses. Think of this as a world-wide Hand Washing In-Service for reducing transference of illness. If washing hands is not an option, hand sanitizer with at least 60% alcohol is recommended.
Avoid touching eyes, nose, and mouth. This is good practice for nail biters, and those with acne prone skin like mine.
And lastly, please don’t wear facial masks or coverings if you’re by yourself at home, driving, or anywhere alone where there are no person-to-person contact. Reduced airway may be unsafe for long periods of time.
If you happen to get sick; treat it as any other illness, contact/stay in touch with your doctor, most people that contract COVID-19 have a mild illness and can recover at home. Don’t leave your home, contact your local pharmacy (support local small businesses!) and ask them about delivery. Rest, and stay hydrated. Use over-the-counter medication as needed (consult your doctor), such as acetaminophen to reduce symptoms.
*Seek Medical Attention if:
You have trouble breathing
Persistent Pain or Pressure in chest
New Confusion
Inability to wake, stay awake
Blue color lips or face
Some of these symptoms may feel real if you’re feeling anxious about having the virus. With the shift in routine and the lack of social interaction, our mental health may be compromised. For precautionary measures, if you're feeling unsure if you’re having trouble breathing, you can purchase a Pulse Oximeter to make sure your Oxygen level is in the normal range- above 95% for those without pre-existing respiratory illness. If it dips below 93%, the CDC recommends supplemental Oxygen for those with COVID-19. Basically, if your Oxygen level % Saturation dips below 95%, contact your doctor.
If you’re worried about a loved one that you don’t live with, utilize video calling platforms like Facetime, Zoom, Skype to check up on them. But also stay calm, stay social, we need to take care of our mental health just as much as our physical health.
Any other questions can also be directed through my site! Feel free to email me at smplytherapy@gmail.com. You may also message us @smplytherapy on Instagram, or Facebook.com/smplytherapy/ !
References
https://www.washingtonpost.com/science/2020/03/31/coronavirus-human-connection-social-distancing/
https://genomebiology.biomedcentral.com/articles/10.1186/gb-2007-8-9-r189
https://pubmed.ncbi.nlm.nih.gov/20668659/
https://www.sciencedirect.com/science/article/pii/S2095254618301005
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590612/
https://pdfs.semanticscholar.org/0ec4/ca4cbefa851f3d078f83ea8ef61b4a623bf9.pdf
https://rightasrain.uwmedicine.org/well/health/hygiene-hypothesis
How to Help Your Little One Wear Masks During COVID-19
Wearing masks has quickly become a norm in today’s world due to COVID-19, this may feel odd for adults, and especially the little ones. Facial masks are not required for children under 2 years old, but that leaves a good amount of kiddos that may not understand how to adapt and feel comfortable with their mask. Here are a few things to consider when preparing for the necessary food shopping, or errand;
There are a few reasons your child may have difficulty wearing the mask
Anxiety - the sensation of airflow is different and may feel like they are suffocating. This is tricky because masks that protect your child will have a thicker threshold for them to breathe into.
Sensory processing - the feeling of the mask on their face and ears may cause discomfort.
Visual input - If your child wears glasses, they may fog up, and the mask reduces the visual field for looking down.
Smell - I think we’re all a little more conscious of our breath when it’s our only source of air.
Here are some tips
To address the anxiety I would recommend a social story (example provided at the end of the article)
Show pictures with family and friends with masks
Talk calmly but directly about the importance of the mask prior to outing
Play with a stuffed animal and have them putting the mask on them
You may use a visual timer at home to increase time with mask on
Don’t force the mask!
Brush teeth before leaving the house, or have a mouth freshener handy
If your child wears glasses, he may benefit from putting a piece of tissue between bridge of nose and mask to reduce fogging up
If you’re handy with sewing, you can sew buttons on a hat or headband as a secondary option to looping at the ears. Some are available online.
When picking a mask for your child- opt for a soft (possibly cotton) fabric, allow them to choose the fabric if available.
Add the mask to a costume! Make it fun with a halloween costume you might have handy and wear other parts of the costume. Maybe even add a piece of candy for a temporary spring halloween.
Some kids may be adverse to smells, but you can try adding a calming essential oil to a small piece of cloth to place inside the mask
Use of a fidget may help to keep hands busy and redirect focus on something else
For those with medical conditions like Epilepsy, seeing changes in facial expression is essential for distinctive pre-seizure facial expressions. For those children they may be medically exempt by a physician. There are also some masks sold with clear sections at the mouth if that is what their parents prefer.
For those on the Autism Spectrum or with Sensory Processing Disorders, children may have an especially difficult time with masks. This is due to increased sensitivities for the way their body processes clothes and new experiences. The important thing is to not force the mask, try some of the tips above to help transition, start with the social story, have them play with a stuffed animal to put the mask on them.
Social Story by Autism Little Learners- https://drive.google.com/file/d/1B2FEF1DTXpmgH8ZL79Vg7E_Bu7ZOkB0A/view
If you have more questions, we are always here to help. Email us at smplytherapy@gmail.com or book a session!
The Real Deal with ADHD
We often hear people say that they think they may have ADHD if they are having trouble focusing on school or work. ADHD is a well known diagnosis that people may misinterpret or misdiagnose.
If you have ever wondered if you may have ADHD, it’s always best to speak to a doctor. However, here is some background on the topic in order to help those that are curious.
Etiology is unknown, however there are suggested contributing factors including:
Genetic factors - higher occurrence in monozygotic twins than in dizygotic twins, 2X the occurance in siblings of hyperactive children. This leads us to believe there’s a correlation in passing it down in families.
Neurological factors - possibility of minimal brain damage due to circulatory, toxic, metabolic, or mechanical effects during fetal development, and infection inflammation, and/or trauma during early childhood.
Neurochemical dysfunction related to neurotransmitters in the adrenergic and the dopaminergic systems.
Psychosocial factors - stress, anxiety, or predisposing factors such as temperament.
According to the American Psychiatric Association (APA) there are three types of ADHD as defined by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). There are three subtypes of ADHD; Predominantly Inattentive type, Predominantly hyperactive-impulsive type, and Combined type. Depending on the symptoms, your doctor will be able to diagnose your subtype.
Symptoms
Symptoms are often noticed during the early childhood years before 3 years of age. However, caution is advised on early diagnosis and will most often be made during elementary school years when behavior is interfering with school performance. Some other notes on symptoms:
Occurs in 5%-8% of elementary school aged children.
Prevalence in boys to girls is a 3:1 ratio, most common in first born boys.
Partial remission may occur in ages 12-20. Hyperactivity may disappear during these years to allow for a productive adolescence but distractibility and impulsivity can persist.
Symptoms persist into adulthood in 60% of cases.
Diagnostic Criteria
Presence of 6 or more symptoms are required in three Domains (or subcategories).
Symptoms in the inattention/hyperactivity domain that interfere with occupational activities are present for at least 6 months.
Inattention Domain Symptoms may include: lack of attention to detail, poor listening, limited follow through of tasks, difficulty with organization, and avoidance of tasks that require sustained attention, tendency to lose things, distractibility, and forgetfulness.
Hyperactivity Domain Symptoms may include: fidgeting, inability to remain seated, inappropriate activity level for a given situation, difficulty with quiet sedentary activities, frequent movement and excessive talking.
Impulsivity Domain Symptoms may include: answering questions before they are fully stated, difficulty with turn taking, and interrupting the conversations of activities of others.
Other symptoms that may be present: Visual-perceptual, auditory-perceptual, language, cognitive problems.
Some of the symptoms presented were evident before the age of 7.
Symptoms result in difficulty in 2 of these settings: school, home, and/or work.
Symptom management
Medication as prescribed and monitored by a doctor, Psychotherapy, behavior modification, parent and individual counseling may be indicated.
Impacts on function
Infants may be overactive, difficult to soothe when crying, and demonstrate poor sleeping habits.
You may see defensiveness to environmental stimuli, frequent irritability, aggressive behavior, emotional lability, and unpredictable performance. These are all in response to difficulty with attention, it creates a barrier to learning and performance.
There may also be disorders in school related tasks or learning disabilities, which can be assisted with a team approach to your child’s care at school.
Caregivers may also see an increased risk for depression due to frustration and difficulty with learning. Checking up and addressing your child’s self esteem is important during this time to avoid progression. Those with symptoms remaining in adolescence and adulthood are at an increased risk of antisocial personality disorders, and substance-related disorders.
Considerations for Occupational Therapy
Occupational Therapists will work with children and their families on behaviors that may contribute to difficulty in school, play/leisure, and social participation. This may include environmental modification for facilitated learning, training in social skills/self-management, promotion of sensory modulation. Consultations to family, teachers, and employees regarding strategies are also implemented for treatment.
If you have any questions, please feel free to reach out to me directly smplytherapy@gmail.ccom
References
Glanzman, M. M., & Nathan J. Blum. (2007). Attention deficits and hyperactivity. In M. L. Bathshaw, L. Pellegrino, & N. J. Roizen (Eds.), Children with Disabilities, 6th ed. (ppp. 345-365). Baltimore, MD: Paul H. Brooks
American Psychiatric Association. (2000). DSM-IV-TR: Diagnostic and statistical manual of mental disorders, text revision, 4th ed. Washington, DC: Author.
What is the difference between OT and PT?
This is a question I get asked a lot, and for good reason. What I’ve noticed is that, unless you have a child that received services, or a parent you have supported while at a rehabilitation center, it’s difficult to understand the difference. In many settings, the OT and PT will be working together on a case very closely because there may be some overlap in treatment. Academically, both professions require similar schooling- OT/PT students shared the same classrooms for Anatomy and Physiology. However, our differences come into play with the theories that define the outlook and goals for our treatment.
Theories refer to the outlook on treatment – think of it like choosing your political view. Physical therapy only uses a Biomechanical Model of improving performance. PTs focus on Strength, Range of Motion, and balance for improved gait (walking), and transfers (moving from one position to another). Occupational Therapists are trained in the Biomechanical Model, but also a range of other theories that reflects training in psychology, sociology, communication and the way we perform functional activities. A simple analogy - Physical Therapy are like body builders performing reps to build muscle, and Occupational Therapy are the Yogi’s or Dancers. Both groups are athletes and may look similar and work on the same muscle groups, but they have a different approach. The setting also determines the way Occupational Therapists perform treatment.
In Acute settings OT focuses on Activities of Daily Living (ADL’s). ADL’s are defined as daily occupations performed at home that are required to get back to your routine, typically it includes tasks in Toileting, Dressing, Hygiene, Bathing. Insurance companies and the Interdisciplinary team (nursing, social work, MD, etc) want to see that you can perform these tasks safely and independently before discharging to the home. Your Occupational Therapist is the person that will ensure your independent mobility with exercise and functional activities in treatment. Let’s say an 80 year old woman breaks her hip and gets a hip replacement, after a couple days in the hospital the doctor deems her unsafe to return home because she can’t go to the bathroom on her own or walk. Instead, they send her to a Sub-Acute Rehabilitation where an OT will work on her ability to perform ADL’s on her own, and PT will work on her ability to stand, walk and climb the stairs needed at home.
In Outpatient settings, or a Hand Therapy Clinic, there are specialists called Certified Hand Therapists (CHT) for injuries of the Upper Extremities. This is for those that may have had a work related injury like Carpal Tunnel (refer to the Ergonomics Blog Post!), and need surgery, or someone who fell on ice and broke their wrist. Believe it or not, 70% of Certified Hand Therapists are Occupational Therapists, 30% are Physical Therapists. In this setting, splints or devices to help the joint heal properly are made or fitted by your therapist. This is in combination with exercises specific to your needs to ensure safe return to daily activities. In this setting, the two are very similar. In some settings, people define OT as upper body specialists, and PT for lower body injuries, but there is a clear difference in the assessments we perform and the way we document treatment.
In Pediatric settings, Occupational Therapists have the best job in the world - to play with babies! This comes with strategic play. Just as in the other settings, we evaluate where a child is struggling or has a developmental delay, and plan an activity to focus on improving those areas of difficulty. The children seen in occupational therapy may have a diagnosis of Autism Spectrum Disorder, Down Syndrome, ADHD, or a Learning Disability, but many times they may go undiagnosed. That's where our specialty is our strength, we assess all different areas of the way your child processes their world from attention, the way they hold a pencil, how they process sound or vision, social communication, and we can differentiate behavior difficulties from sensory processing difficulties. OT’s in this setting will report on behaviors, abilities to perform fine motor and gross motor tasks, communication, visual attention and ability to perform ADL’s, PT’s will focus on strength, posture, and mobility. The two disciplines may overlap, especially in this setting, but the differences are more clear in the documentation and goals for treatment.
Occupational and Physical Therapists are the twins that keep getting confused with each other, not to mention our third sibling Speech Therapy. We’re all healthcare professions that are needed in similar settings, and get grouped together for insurance reimbursement. However, we each belong to different national associations and have different specialties.
I hope that helps those of you that were confused! If you have questions, please feel free to reach out to me at smplytherapy@gmail.com
The Importance of Ergonomics
Going into the second month of working from home, maybe some of you are recognizing some new body aches that you haven’t felt before. With the recent move into your new “home” office, you may realize that your posture has been worse than ever because of this new workspace.
Some of you may have written it off as temporary but it’s important to make adjustments so that it doesn’t have the potential to do long term damage.There are many new technologies popping up on how to get your back straight with postural devices to maintain good posture, but there’s a cheaper solution - adapting your workspace to facilitate good posture is the best way to maintain upright posture. If you're looking down at your laptop because it’s resting on your lap… 8 hours a day, 5 days (or more) a week - your back and neck are hunched over in order to lower your visual field, thus creating bad posture. It’s amazing how technology has allowed us to work from home in many aspects, but proper positioning for computer tasks is really important to reduce strain on your body. Laptops are not generally encouraged, but if you’re like me and it’s your only option- there are ways to optimize your posture.
Ergonomics is a specialty area of Occupational Therapy that works with businesses to reduce the risk of injury at the workplace. Occupational Therapists look at the broader spectrum of a person and are trained in task analysis to improve performance. If you reflect on your physical aches and pains, most of the time it’s because of micro-injuries over time. For the average American, much of that points to your workplace positioning or movement. You spend most of your waking hours at work, whether it’s seated at a desk or lifting items - proper positioning is most important when it’s repeated again and again.The idea is to refrain from using the same muscles, in the same way for long periods of time.
We all have a budget and may not be able to afford the perfect workspace, I will do my best to give you options that may be adaptable with the things you already have at home.
A Few tips on positioning for desk and computer set-up…
Try and stretch every 30 mins, getting up and repositioning
Standing and leaning back
Rolling wrists
Stretching neck side to side
Shoulder rolls and arm raises
Personally, my legs get restless- so my solution is doing simple squats sets of 10 reps
Even when it comes to work specific devices, or utensils- working smart is important. Things like the use of a food processor to cut up onions, tomatoes, and garlic will help preserve your joints if it's repetitive (bonus for saving tears!). If you do a lot of writing, or use devices with handles, the larger the handle, the easier it is for you to grip and it won’t put as much pressure on the small joints of the hand. Most of these adaptations are not needed for infrequent activities, but if your job requires specific repetitive movements, it’s important to preserve your joints.
At the desk, most of us are using an office which has been transitioned to home. Things to be mindful of:
Wrists should be in a neutral position (not flexed up or down)
Elbows should be in a 90 degree angle, supported by desk chair
Hips should be at a 90 degree angle
Knees should be at a 90 degree angle
The computer monitor should be at eye level with your neck in neutral (not bent up or down)
With a laptop some of the above may be difficult because the keyboard is so close to the screen. There are laptop stands that adjust the positioning so that the screen is closer to eye level with the keyboard angled down so the wrist joint is closer to neutral. Your elbows may not be in 90 degrees as they were for the laptop on your lap, but if we’re addressing the back and neck pain, we want the screen as close to eye level with shoulders back. Also, if you have any wrist pain radiating to your hand, the track pad may be the culprit. Opt for a detachable mouse for better preservation of your joints.
For those at desks...
Chairs should be adjusted to hips and knees at 90 degrees, if not possible, try using a seat cushion/pillow to get there. Keep mindful to accommodate your elbows at 90 degrees, you can add a textbook/box at your feet, or textbook underneath your monitor for quick fixes.
Occupational Therapists can help you to implement more efficient ways to move and set up your work-now home space to promote healthy joints and minimize repetitive movements. Contact us or book a session for consultation on your ergonomic evaluation.
What is Deep Pressure Touch, and how does it relate to your Gravity blanket?
Everyone remembers the electric blankets right? It was a staple in my household during the winter season - until they started shorting out and causing fires. You don’t see as many electric blankets anymore, but the new craze is Weighted Blankets! You’ve probably seen ads and commercials for them and may have even bought one from Amazon, but did you know they’ve been used by Occupational Therapists for decades?
I want to explain from an Occupational Therapist’s point of view of how the basics of weighted clothing and blankets work. To start, we all have Sensory Systems. The usual ones we hear about are vision, olfactory (smell), auditory, gustatory (taste), and tactile (touch). But there are other systems called the Vestibular which dictates your sense of balance, spatial orientation, and Proprioception, which processes your body’s ability to “sense itself” in space or boundaries. It may sound overwhelming, but much of it is instinctual. For example, your ability to follow the Yoga instructor strictly based on their verbal cues is because of your proprioceptive system (your vestibular system helps hold the position). It’s basically your body knowing what to do without seeing yourself, and you have an entire neurological system devoted to that.
To dig even deeper - Deep Pressure Touch (DPT) is a mechanical deformation of the skin coupled with stimulation of the underlying facia and periosteum (Mountcastle & Daruab-Smith, 1968). Basically, it’s a somatosensory sensation similar to a hug, cuddle or squeeze. Hugs are scientifically proven to have a calming effect on the body. Occupational Therapists use DPT for kids with hyperactivity, distractibility and tactile defensiveness for children struggling with sensory processing, and may be applied to people of all conditions for a calming effect. This may not work for everyone, but it is noninvasive and has no adverse side effects, so it’s worth a try!
When the commercial says that the weighted blanket helps you calm down and relax, it’s a technique that Occupational Therapists have been using for over 20 years. With the help of an evaluating occupational therapist, you can understand which system a child needs to be addressed in therapy and if this technique will help with behaviors. It has been shown that children with Autism (part of their diagnosis includes difficulty with sensory processing) who wore weighted vests had an 18-25% increase in on-task completion of fine motor activities (activities that include the small muscles of the hand) (VandenBerg, 2001). The weighted blankets are great for when at home, or in a calm space where one can relax, but OT’s tend to use something that can be worn like a vest, to incorporate it into a functional task. Weighted clothing and blanket’s may not work for every child, but it does seem to improve some children’s performance for school tasks.
The best way for you to understand your child and see what techniques will help your child learn is with an occupational therapy evaluation. This involves a specialized testing of physical skills, social communication, and sensory processing to help understand underlying factors that may be inhibiting learning.
To learn more, email us at symplytherapy@gmail.com or schedule a consultation.
References:
Effects of a Weighted Vest on Attention to Task and Self- Stimulatory Behaviors in Preschoolers with Pervasive Developmental Disorders. (2001). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12959227
How to Keep your Child(ren) Happy, Productive and Engaged during "Stay at Home"
Three weeks into staying at home, children running across a Zoom conference call or dogs barking has become “normal.” As we all prepare for the possibility of another month of working from home, it seems as if homeschooling has become somewhat more manageable. However, parents are still voicing concerns over a sedentary lifestyle and too much screen time.
As an Occupational Therapist, I want to first note that note that screen time is perfectly ok, but it’s okay as long as it’s supervised. While they are on a laptop, computer, phone, or tablet, they can still build and engage muscle groups. We will get into that shortly.
Secondly, let’s talk about the how important it is to manage the more sedentary lifestyle. As school age children are still developing, it’s important to pay attention to posture and muscle building.
Adding a couple of postural changes may help their bodies maintain a level of strength, it could be as simple as having them play on the device on their stomachs on the floor. This position will help them strengthen and elicit core muscles that aren’t engaed if they were laying on their back. If you happen to have an exercise ball or a low ottoman, this could also add a balance challenging aspect to it by having them lay on their stomachs (on the ball or on the furniture) so that weight is distributed to their arms for support during screen time. If your child finds this difficult, you can allot for a certain amount of time in the position with a timer on your phone.
Here are some tips for integrating muscle building while at home or doing schoolwork:
Having your child complete writing or drawing activities with paper propped up by an easel or taped up on wall. This increases strength in supporting muscles important for improved posture.
Make obstacle courses to complete activities or games. Adding bunny hops and frog jumps as a prerequisite to make a move for Jenga or completing a puzzle adds input into joints that may help them relax and stay calm for the activity.
Make chores fun! Make a game out of normal household chores, such as folding and sorting laundry. A few ways to make laundry fun:
Challenge them on how quick they can match socks – this could help with visual skills and cognitive identification.
Button shirts or folding clothes (if age appropriate) - this works on the small muscles of the hand and coordination
Identifying all the colors, how many colors are there?
Sorting into categorical piles
Laundry isn’t the only way to turn household chores into developmental games. This can be done with cooking or cleaning. Creating an opportunity for them to assist you around the house will keep children active and it will also prepare them for independently doing household tasks once it’s age appropriate.
To close this blog, I want to circle back to my previous blog of addressing picky eating. Because you are spending more time at home with your child(ren), you have an opportunity to address some of the picky eating behaviors. This is a wonderful chance to incorporate different textures and flavors and increasing their exposure to new foods. Asking your child to assist in food preparation is a way to get your child to interact with the food, understand the texture, and incorporate different smells. This adds to their repertoire of familiar foods, increases the likelihood of trying new foods, and keeps them busy!
You can also make cooking fun but having them helping with stirring - this gives good input into joints for relaxation while also working on coordination and strength of upper body. They may also help with washing vegetables, retrieve items from the fridge or for a recipe- this works on coordination, motor planning, visual scanning, and cognitive skills.
If you are unsure whether your child(ren) are age appropriate to start chores. Here are some basic guidelines for age specific milestones for household management tasks:
13 months - Imitates household work
2 years - Picks up and puts away toys with parental reminders, copies parents domestic activities
3 years - Carries things without dropping them, dusts with help, dries dishes (with parental supervision), gardens (with parental supervision), puts toys away with reminders, wipes up spills
4 years - Fixes dry cereal and snacks, helps with sorting laundry
5 years - Puts toys away neatly, makes sandwiches, takes out trash, makes bed, puts dirty clothes in hamper, answers telephone correctly
6 year old - Simple errands, household chores without redoing, cleans sink, washes dishes with help, crosses street safely
7-9 years - Begins to cook simple meals, puts clean clothes away, hangs up clothes, manages small amounts of money
10-12 years - Cooks simple meals with supervision, does simple repairs with appropriate tools, begins to do laundry, sets table, washes dishes, cares for pet with reminders
13-14 years - Laundry, cooks meals
If you have any questions, please reach out to Kristin at smplytherapy@gmail.com or book a consultation with me!
Why Is My Child a Picky Eater?
However, if you are noticing that your child is struggling to try new foods and is extra picky, this should trigger a red flag.
Many kids can be picky eaters. However, if you are noticing that your child is struggling to try new foods and is extra picky, this should trigger a red flag. For many parents (especially first time parents), many food related symptoms may seem to be ordinary. After all, parents make daily attempts trying to get picky eaters to eat healthy and nutritious meals. The unusualness in these symptoms depends on the frequency, intensity and disruption of everyday life. These disruptions may lead parents to seek medical evaluation.
Food related sensory processing issues or sensory processing disorders can be due to many reasons:
Oversensitive to sensations of the different textures of food - This is known to Occupational Therapists as oral defensiveness. Typical reactions include gagging on solid food, strong flavors or lumpy textures
Oversensitive to smells – Here’s a fun fact, most people can only taste 5 flavors (bitter, sweet, sour, salty, umami), the other complex flavors are attributed to smell. When your child experiences sensory processing disorders they may seek bland food as a result
Sensory seeking children may dislike bland or soft foods, and seek crunchy, high texture or highly flavored
Sensory based motor disorders may avoid foods that take high coordination to eat, these children may have difficulty using utensils
Children with poor muscle tone (muscle weakness due to neurological reasons) may have trouble with chewing, or oral motor coordination, may prefer foods that doesn’t need to be chewed
Not all finicky eaters mean that there’s a problem. Here are some ways to address picky eating:
Figure out what is causing the picky eating - if your child is gagging or vomiting- this is your child’s brain warning them of danger. It’s best to seek an OT as a result of over-responsiveness to sensations, and cannot be overridden by reason
Baby steps – create a list of foods they do enjoy and what nutrients they may be lacking. Some questions to consider - are there any ways to update current foods with a healthier brand, is there any way to change the presentation of a the food to give it a friendlier appearance?
Respect your child’s response - this is important to build trust. We would advise against tricking your child into eating something they are refusing, or sneaking it into an item that doesn’t allow your child to choose accepting it
Offer, don’t force! - Allow the child the autonomy to choose or try something. Again, by building trust with your child and letting them accept foods slowly will increase their food choices. You get to decide what to serve and when. Your child gets to decide whether to eat it, and if so, how much.
Set Guidelines and routines – When a routine is set (as much as possible), it helps to decrease anxiety associated with mealtime, and increase feeling of control for your child
Encourage your child to experiment with adverse foods! - Not necessarily at mealtimes, but during play/free time to improve relationship with food
Old with the new - Offer the familiar and loved foods with new foods. Introducing new foods without any familiar foods might increase defiant behaviors and result in your child withdrawing from trying anything
Trial - It can take about 15 tries of a food for kids to accept it. Any interactions (sight, touch, smelling) with the food is a step in the right direction and is increasing exposure
Of course, there is more than one way to address sensory processing issues and each child is different. If you have more questions, please feel free to reach out to us at Smplytherapy@gmail.com or schedule a consultation here.
What is Occupational Therapy and When do you need it?
Occupational therapy (OT) teaches people of all ages how to adapt to everyday life.
True of False? - Occupational Therapists help people find jobs.
This is absolutely false.
I’m Kristin, Founder of SmplyTherapy, Welcome to my page and blog. Having been in the field of Occupational Therapy for many years, I’m very aware that there are many people who do not know exactly what Occupational Therapy is. If you’re here, you must be curious if Occupational Therapy is right for you or your loved one. First, I want to take you through some basics about Occupational Therapy.
What is Occupational Therapy
Occupational therapy (OT) teaches people of all ages how to adapt to everyday life. According to The American Occupational Therapy Association, Occupational therapy is the only profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities (occupations). Occupational therapy practitioners enable people of all ages to live life to its fullest by helping them promote health, and prevent—or live better with—injury, illness, or disability.
Common occupational therapy interventions include:
Helping children with difficulties or behavioral problems to participate fully in school and in social settings
Assisting people who are recovering from injury to regain everyday skills
Providing support for older adults experiencing physical and cognitive changes
Who are Occupational Therapy Practitioners?
Occupational therapy practitioners (also may be called Occupational Therapists or OTs) are healthcare professionals with a holistic perspective who uses evidence-based practice that is deeply rooted in science and research to promote a patients' functional capability to accomplish their daily routines.
OTs have vast training and understanding of how to treat the whole body by combining neurological principles, anatomical / physiological concepts, and psychological perspectives.
How does Occupational Therapy work?
Typically, Occupational Therapy services will involve:
Individualized evaluation in which a client’s needs are assessed. The evaluation may take place in your home, workplace or a child’s school
Therapy plan and goal setting designed for you (or your children’s) needs and limitations
Customized intervention to improve the person’s ability to perform daily activities and reach the goals
Outcomes evaluation to determine is goals are being met and / or make changes to the customized plan
Who needs Occupational Therapy?
Often times, people simply do not receive the help they need in order to improve their lives because they are not sure what they need.
I speak with many young or first time mothers who may recognize their young children are more fussy than others but do not know where to go to seek help other than their pediatrician. Often, the parents may be referred to an Occupational Therapist who can help to evaluate and get the proper support for their children. Occupational therapy has been known to help children with ADHD, juvenile arthritis, and autism.
However, Occupational Therapy isn’t just for children. Anyone who struggles to do everyday tasks may benefit from it. If you have any of the health issues below, you may consult your doctor and see if occupational therapy can help you:
Arthritis and chronic pain
Stroke
Brain injury
Joint replacement
Spinal cord injury
Low vision
Alzheimer’s disease
Poor balance
Cancer
Diabetes
Multiple sclerosis
Cerebral palsy
Mental health or behavior issues
You can also schedule a consultation with me to see if Occupational Therapy is right for you.