Thursday, November 29, 2012

Kelly's Holiday Shopping Hints


Around the holidays there are always toys that seem to become an item that is competitively shopped for, when I was younger I can remember the craze for ‘Tickle me Elmo’.  But before buying your little ones gifts for the holidays because they are the new ‘it’ toys, consider the following while shopping this year:

1. Use your IMAGINATION: Can the toy be played with in different environments and used for different contexts?  Try to find a toy that encourages creative play. A lot of toys today are automatic or electronic and don’t leave much to the imagination.  Get back to basics and get toys such as blocks, Leggos, Lincoln logs, a kitchen set, action figures or dolls/dress up sets, all of which are a great way to get involved in play with your child and facilitate conversation and using your imagination.


2. Does the toy encourage FINE MOTOR manipulation?  The first few years are crucial for developing important skills.  Toys such as inset puzzles/shape sorters are great for visual perception and fine motor manipulation.  Fine motor pop-up toys provide a great opportunity to learn with trial and error and require use of fine motor strength and manipulation (pushing, pulling, pinching, turning, sliding). Also try and think if the toy requires the child to use both hands together to help develop bilateral hand skills (using hands together).  Zoom ball is a great game for bilateral hand skills in addition to self-regulation, hand-eye coordination and it requires two players so it is a great way to facilitate fun interaction.  An easel is also a great playful way to use fine motor skills.  In addition, working on an easel requires your child to use their muscles! Holding a paintbrush (or their fingers) up to the paper for long periods of time is a great way to develop those key muscles (core strength, upper body)
 



3. Think SENSORY:  Does this toy require use of more than one sensory system?  Toys that light up or make noise or have a stimulating texture are great for your little one if they require a little extra for arousal, toys like these can really bring out the playful side.  I also love light up toys for calming play before nap time or bedtime (Glo-doodle, glow in the dark pillow pet).  Remember that each child with has different sensory needs and defenses, consult with your occupational therapist for sensory toys that would work best with your child!



4. Does the toy encourage MOVEMENT?  For those overactive tykes, games that require movement are great!  One of my favorites is hullabaloo.  This game not only encourages movement but also requires the child to attend to auditory directions, use visual perception and it can be played with peers/siblings to encourage social interaction.  Velcro grab and catch is a great way to improve hand-eye coordination and provide a successful opportunity for your child to catch a ball if using a glove is a little too hard.


 




5. Does the toy help promote use of COGNITION?  Toys mentioned previously such as puzzles/shape sorters/pop-up toys are great for the younger ones.  If your child is a little older, interactive board games can be great for planning, thinking, and facilitating conversation such as ‘guess who’.  One card game I love is ‘blink’ by UNO, it is a matching game that requires your child to match by either color, shape or number.

 




***I also want to recommend using Toys “R” Us Guide for Differently-Abled Kids.  You can search online for your child based on skill (language, fine motor, visual, tactile etc….), you can also narrow your search by age, gender, brand and price.  I highly recommend using this site as a guide for your shopping!!!

Each child has different needs, if you a still struggling with what to get for your child, contact your occupational therapist to get some ideas as to what would be best for the needs of YOUR child.




Monday, November 26, 2012

Let's talk about sensory processing

Lets Talk Sensory Processing- By: Kelly Martin, OTR

The term sensory processing refers to the way that our nervous system receives sensory messages and turns them into physical responses.  For example, have you ever been preparing a meal and walked away from it and all of the sudden you smell something is burning? Your sensory system processes this information and elicits a physiological response, your heart rate increases and you rush to the kitchen to quickly turn off the stove.  This is your sensory system in action.

Children with sensory processing disorder have trouble integrating the sensory information they receive with an appropriate response.  The way I have always explained SPD to parents is simple, every person processes sensory information in their own way.  For example, some people might enjoy the smell of something that others find noxious.  Personally, I do not wear wool clothing because my tactile system finds it irritating- however this is not the case with most people.

For children with SPD, their defenses can be so significant that it impacts their day-to-day interactions.  With a similar example, a tag on their shirt may irritate some children, so much so, that they are not able to focus on important tasks in school because they are hyper-focused on the tag that is bothering them.



Children can be impacted by SPD in countless ways.  This is referred to as their “profile” they may be over responsive to auditory input but under responsive to movement or vestibular input. These factors are indicative of a possible sensory modulation disorder.  A child may be clumsy, uncoordinated or “just not athletic”  These are all possible identifiers of a sensory based motor disorder.  Another child may have difficulty identifying the direction with which noises are made, they may have difficulty  eating certain foods secondary to their texture, these are factors that may be indicative of a sensory discrimination disorder. In short, Sensory Processing Disorder is an umbrella term that encompasses three identified subgroups (Sensory Modulation Disorder, Sensory Based Motor Disorder and Sensory Discrimination Disorder) and further into the subtypes of each subgroup. To make things more difficult and confusing, most children to not fit neatly into one subgroup or category.  (See figure below)

Here is a quick description of the subtypes of sensory processing disorder and the terms commonly used to describe the subtypes:
Subtypes of Sensory Modulation Disorder:
Sensory over-responsivity (SOR): SOR is a term that describes a persons response to sensory stimuli as more intensely, quickly and for a longer period of time.  This child is over registering sensory input.   The child's response to such input is described as “fight or flight”, they may avoid certain types of sensory input or they struggle to control their environment as a means of protecting themselves or limiting the potential for such input to occur.

Sensory under-responsivity (SUR): Children with this subtype under register sensory input. These are children that exhibit less of a response to sensory information than the situation demands, i.e. taking longer to react. These children may show a low affect, they may be lethargic, socially withdrawn, they may have poor posture or may be under responsive to pain and temperature.

Sensory seeking (SS): Children that are sensory seeking (SS) CRAVE sensory experiences and will actively seek out ways to get what they are looking for, sometimes in socially unacceptable ways (pinching, pushing, spinning, crashing to the floor) which may appear, to some, as a child that is simply “misbehaved”.  In school this may be the child that moves around non stop, bumps into people when standing in line or likes to sit in the teachers lap or very close to others when at circle time.

Subtpyes of Sensory Based Motor Disorder (SBMD)-

Dyspraxia- The term Praxis refers to plan and execute a motor task. Dyspraxia refers to a persons inability to plan, coordinate and execute both familiar and non familiar movements.  A child with dyspraxia may be described as clumsy, uncoordinated, or avoidance of movement.

Postural Disorder- Children with postural disorder may have low muscle tone, weak musculature specifically in the trunk or stabilizing muscle groups such as the shoulders, hips and abdominal or back.  These children will have poor seated posture, they may fall out of their chairs often, slump over their desks or rest their heads on the desk while working. They may have difficulty sitting on the floor at circle time or participating in playground play or during PE class.

Sensory Discrimination Disorder- (Tactile, Auditory, Visual, Gustatory, Olfactory, Proprioception, Vestibular and Interoception) 
We all know our five senses, we learn them as early a Pre-School.  They are your auditory, gustatory, olfactory, tactile and visual sense (hearing, tasting, smelling, feeling and seeing)  Three other senses that are crucial to a persons ability to effectively discriminate the world around them.  These are the vestibular and proprioceptive systems as well as interoception ( movement sense, position sense)  Children with sensory discrimination disorder have difficulty identifying differences or similarities of input.  An example would be the ability to decipher the difference between a penny and a quarter in the hand without looking at the coins or reaching into a desk and being able to pull out  a pencil amid folders, notebook and markers.
           
As an occupational therapist, it is my goal to improve my clients’ occupations, for children, this means schoolwork, play and self care. SPD can often impact these occupations greatly.  I found this chart that I this is not only cute but also helpful in explaining the 
breakdown of our sensory systems and some tips for activities or modification:











Tuesday, November 20, 2012

Introducing Myself and My Journey To Occupational Therapy- By: Kelly Martin, OTR


I would like to introduce Kelly Martin, our newest addition to the OT-Kids team and a wonderful therapist that I had the opportunity to train as a Level II fieldwork student. Kelly proved herself during her fieldwork placement and I was so excited when she accepted my offer of employment after she completed her academic program and successfully completed her National Exam.  Kelly will be a regular contributor to this blog and will be working with children in the home, school and clinical settings.  Here is a little blurb from Kelly on her journey into the profession of occupational therapy!

"I first heard about occupational therapy while in my undergraduate program, I thought to myself, "What a great job".  The more I looked into it the more I fell in love, however, when I found out all of the hard work that went into getting into the graduate program, I thought, I could never do that…But I decided to give it a shot, I took all of my prerequisite courses, earned my undergraduate degree with a bachelor of science in psychology and made it into the very competitive graduate program at Sacred Heart University.  When I first started classes (including: pathology, anatomy, kinesiology, neurology), I thought, “How will I ever do this”? Again, I gave it my all and made it through my classes and began fieldwork, this is when I knew it was all worth while.  For my level I fieldwork I was placed in the school systems, and right away I developed a greater love of this profession, specifically in the pediatric setting.  I chose to complete my Level II experience in a sensory clinic, and was placed with Kristi at Connec-To-Talk. Within my first week, I said to myself "I couldn’t not imagine doing anything else".  In this hard economic time, I see my friends that graduated still trying to figure out what they want to do, or working in a career that they do not enjoy.  I feel extremely lucky to have found a career that has become a passion.  I look forward to continuing my learning and sharing my knowledge through this blog to advocate for a profession that I feel so strongly about"! -Kelly Martin, OTR


Wednesday, November 14, 2012

Stocking Stuffers for Toddlers

Thanksgiving is a week away but I already have visions of sugarplums dancing through my head.  Maybe because I was just at the mall and not only was I surrounded by twinkling lights, Christmas carols being piped through almost every stores sound system and posters of upcoming "holiday sales", but I actually bumped into the big guy (yes I am talking about Santa) himself!  Apparently since the day after Halloween, you could have your little one's picture taken with Santa.  Poor Thanksgiving, it seems to get overlooked more and more every year.

One of my families annual Christmas traditions (there are so many) is opening our stockings!  We save them for last.  After we have teared open all of our wrapped gifts and thrown away enough bows to decorate a small town, we eagerly dig through our stockings pulling out chocolates, soaps, nail polishes crossword puzzle books, tiny little do dads that seem to disappear within minutes, a rose for all of the women in my fathers life and finally our very favorite; lottery scratch off tickets!

But this year I have a new dilemma, my 16 month old son! What in the world do you put in a toddlers stocking? Well the Occupational Therapist in me had to take over and push the mommy in me aside for a moment to develop this list.

In no particular order, with no gender consideration this is what I came up with:

Stocking Stuffers for Toddlers (under 3 years)
1. Miniature sized books
2. Bath Toys (foam letters or numbers, squeeze toys, water instruments)
3. Tooth Brush/Tooth Paste set with a new character
4. Matchbox cars
5. Little People (Fisher Price)
6. Stickers
7. Finger puppets (I have seen really cheap ones at IKEA)
8. Removable tattoos
9. Stacking cups
10. Bath Crayons
11. Window crayons
12. Tactile balls or koosh balls
13. Travel sized Potato Head toy
14. Silly Straws (the ones that twist and loop)
15. Spinning tops
16. Egg shakers
17. Maracas
18. Bubbles
19. Refrigerator magnets
20. Socks, hats or mittens

Then I began to think outside the box (It's what OT's do best!).  I began searching for what other parents have suggested and I came across some very interesting, very different and very fun ideas! Here are a few:
1. A package of post it notes for kids to rip apart, stick to things, or draw on
2. A travel package of tissues to keep kids busy for hours pulling the tissues out of the bag
3. Character Band Aides
5. A deck of playing cards (think 52 card pick up)
6. Empty boxes of pasta or macaroni and cheese for stacking and building
7. Roll of toilet paper (let them wrap you up, or better yet, wrap them up tightly)
8. Measuring cups and spoons
9. Egg timers

With all these great ideas, I think I will need to buy Michael a bigger stocking!

Thursday, November 8, 2012

The Emperors New Onsie! A story about a little girl and her struggle with Sensory Processing Disorder

Check out this video! It gives a great description of Sensory Processing Disorder by the mother of a little girl who refused to wear clothing for 6 weeks secondary to SPD.http://vimeo.com/51611834

Here is the article in the Huffington Post today:  It's great to see SPD being written about more and more often.


Twenty-first century parents who want to share their stories have many different media -- paper, TV, radio, the Internet and beyond -- at their disposal. This animated video, produced by Hillary Frank of "The Longest Shortest Time," combines all of the above.
It is the story of what happened when Joyce Slaton's 15-month-old daughter, Violet, stopped wearing clothes for a month. If you want to know why, you canvisit Slaton's blog on BabyCenter or hearmore about it in her recorded interview with Frank -- but we really recommend youwatch the video.
The first time Violet (now 7) objected to a shirt her mother gave her, "hopping around hysterically and screaming" at a library story hour, Slaton was stumped. But when the little girl was ultimately diagnosed with a sensory processing disorder, everything made sense.
“Children, teens and adults with [Sensory Processing Disorder] experience either over-sensitivity (hypersensitivity) or under-sensitivity (hyposensitivity) to an impairing or overwhelming degree,” journalist Beth Arky recently explained in an article for The Child Mind Institute. “Certain people's brains can't do what most people take for granted: process all the information coming in through seven -- not the traditional five -- senses to provide a clear picture of what's happening both internally and externally.”
Slaton was both relieved to get this diagnosis -- she was finally able to help Violet, bringing her to occupational therapy -- and plagued by remorse for ever telling Violet to wear clothes that made her uncomfortable.
"You don't know how guilty I feel of all the times I forced things on her, and now I know that it hurt her," Slaton says in the video.
Radio producer and blogger Frank originally interviewed Slaton about the experience for a parenting podcast. Then, when she was offered resources from the Knight Foundation to make a video, she knew the episode had to be Slaton's story. She added powerful visuals by illustrator Jen Corace and animator Joe Posner. (Read more about the creative process behind the video here.) The final product has been seen nearly 4,000 times on Vimeo.
Violet’s reaction to the video is a moving addendum to the story. Over email, Slaton told HuffPost:
[Violet] put her head on my shoulder and I asked her what she thought, did she feel sorry for that little girl?
"No," she said. "I felt sorry for you, that you had to deal with that." I said back, "Oh, honey, that's a long time ago now. And Daddy and I were happy that we figured out how we could help you." She was silent then, and I asked her, "Would you like it if other kids who have sensory problems could see that video? And maybe it would help them...?"
"Yes," she answered. "And maybe I could explain to them, I know it hurts. But when you get older you will figure out how to make it not hurt."
"The Emperor's New Onesie" was made at a time when many parents are working to understand SPD. A study cited by the SPD Foundation puts a "cautious estimate" of the number of kindergarten-age children affected by SPD at around five percent. And Arky references a "red flags" list from the SPD Foundation that cites "Irritable when being dressed; uncomfortable in clothes" as a warning sign for infants and toddlers.
Slaton says she's heard from parents of other children with SPD since sharing her story. "Many people have thanked me for giving this interview, because it made them feel a teeny bit less alone when they heard it," she told HuffPost. "That was what I hoped for, why I did it, so when I hear that reaction, it is thrilling."