Therapy Threads OT Info

Thinking the best...

2010-02-07T05:47:00.000-08:00

“Love covers unworthy things rather than bringing them to the light and magnifying them. It puts up with everything. It is always eager to believe the best and to put the most favorable construction on ambiguous actions." – Albert Barnes

Fine Motor Skills Activities

2010-02-03T11:34:00.000-08:00

SLP and OT desperately needed!

2010-01-27T13:17:00.000-08:00

If you know of a SLP or OT in search of a job with children, Faces of Hope in Gallatin, TN is hiring both positions. Start date is ASAP. You can see the job posting at:

http://www.careerbuilder.com/JobSeeker/Jobs/JobDetails.aspx?Job_DID=J8E4BX62KD8QWCGNY4Y&siteid=cb_emailjob_US&cbRecursionCnt=2&cbsid=ff58e34239734280bf0d7e093f1c44c8-317924345-x3-6

Fine Motor Skills Winter Activity

2010-01-26T07:40:00.000-08:00

As I sit here looking out the window and watching the snow fall, I'm reminded of a great activity for the kids...snowflakes! The opportunities for fine motor development abounds when making cut-out paper snowflakes. For children with weak cutting skills, you can use tissue paper. Some children need assistance in determining a pattern; you can simply pencil in cutting lines for them. Want to develop shape recognition? Have them use a specific shape for the cuts..."For your next snowflake, use only triangles and see how different your snowflake looks." Don't forget, when everyone has finished, you have a great option for gross motor skills...get out the broom and dustpan to sweep up the cuttings.

Bonus for mom? Keeps the kids busy for hours =)
Enjoy!

I'm banishing the shoulds...

2010-01-20T06:32:00.000-08:00

This article grabbed my attention when it arrived in my "in" box this morning. Words are so powerful. Changing just one word can change your whole outlook on life and how you see yourself. This year, I'm going to retrain myself and teach my children to use the word "could" instead of "should"...

Parenting Thoughts For the New Year: Changing "I Should" to "I Could"
By: Nicole Beurkens, M.Ed.

The start of a new calendar year tends to be a time for us to reflect on the past year, and also make plans for what we envision in the 12 months ahead. Some people make resolutions, write to-do lists, or set goals for themselves. What often happens with these lists and resolutions, however, is that they fall by the wayside shortly after they’ve been written. One of the reasons for this is the pressure we put on ourselves to accomplish these things; and that pressure and level of expectation leads to stress, resentment, and ultimately giving up on what we originally set out to do.

I recently heard someone talk about changing our "I shoulds" to "I coulds." That really resonated with me on a personal and professional level, as it seems so easy to get caught in the trap of stressing about everything I "should" do. When we think of things in terms of "I should," we exist in a pressured state of feeling forced to do something. Thinking about what I "could" do shifts us into a mindset of choice—I am deciding in this moment whether to do this thing. It not only sounds different, but it feels different to phrase options from the perspective of "I could" instead of "I should." There is an internal mindset shift that occurs when we do this; and it allows us to move forward with trying to do the things we could, instead of getting stuck in the mode of pressuring ourselves to do what we should.

Since we are at the start of a new year, we have the opportunity to think about the year ahead in terms of "I coulds." Instead of making lists of all the things we "should" do, why not think about all we could do and accomplish this year? Here are some simple ways we can apply this thinking to our parenting and the relationships we have with our children:

•I could spend a few minutes of 1-1 time with my child each day.
•I could have my child help me with a chore I need to get done.
•I could plan a simple activity that our family can all do together each week.
•I could get the playroom/bedroom/office/garage organized.
•I could be more consistent with my response to the negative/inappropriate behavior my child exhibits.
•I could read that book/journal/blog I find interesting.
•I could be more patient with my children.
•I could set limits for how much time my children spend watching television and playing video games.

How about you? What are some of the "I shoulds" that have been hovering over you and your life? Take a few moments to write down all the "shoulds" that come to mind – just jot them down in whatever order you think of them. Your list might include household chores or projects, such as doing the laundry or repairing something that’s broken; personal ideals such as losing weight; activities with your children, etc. Once you have your list, go through and read each one using the phrasing "I could…". Notice how you respond mentally and physically to thinking about each item on your list as a "could" versus a "should." When these things arise for you on a daily basis, focus on shifting into the choice mode of "I could" instead of the pressure mode of "I should." Let’s make the coming year a year of "coulds!"

--Nicole Beurkens is the director of Horizons Developmental Remediation Center. Her e-newsletter is fantastic. You can find out more about Horizons and sign up for the newsletter at the Horizons web site:
www.horizonsdrc.com

A resolution...

2010-01-01T11:32:00.000-08:00

"A happy New Year! Grant that I
May bring no tear to any eye
When this New Year in time shall end
Let it be said I've played the friend,
Have lived and loved and labored here,
And made of it a happy year." ~Edgar Guest

Pencil Grip

2009-09-17T18:15:00.001-07:00

Here's an easy way to help your child grip a pencil correctly...

Bike Riding Success

2009-09-16T06:26:00.000-07:00

If you're having trouble getting your child to lose the training wheels, try taking them off and remove the pedals from the bike at the same time. Your child can then use his feet to propel the bike, pushing off "scooter-style." This allows children to practice their balancing skills with the safety net of their own 2 feet. When they can coast comfortably, replace the pedals and watch for that beaming smile of accomplishment. And hey Dad, the best part? No running along beside junior's bike!

Don't forget the bike helmet!

Occupational Therapy explained the simple way...

2009-09-10T14:04:00.000-07:00

If you're having a hard time explaining OT to friends and family, this web site might be the best explanation of OT that I have found...No mumbo jumbo, just plain & simple English:
http://kidshealth.org/kid/feel_better/people/occupational_therapist.html#

Thought for today...

2009-09-03T06:17:00.000-07:00

When one door closes another opens. But often we look so long so regretfully upon the closed door that we fail to see the one that has opened for us. --Helen Keller

The journey...that thing called preschool

2009-08-29T11:38:00.001-07:00

Every parent has dreamy visions of their child going off on their first day of school... a bright shiny face, cute hair cut, new, clean clothes, and of course, a full display of the very "best behavior." Our first day of preschool didn't quite follow that script. For starters, students had to be completely potty trained in order to attend. At 4 years and 3 months, our son was still having occasional accidents. He had been a late bloomer...we tried potty training at 2 1/2, but it was obviously NOT going to happen. He simply didn't care and had no desire to learn how. After weeks of frustration, we decided it wasn't worth the stress on all of us. This process repeated itself at 3, but had the same results...no interest whatsoever. At 3 1/2, I knew preschool was coming and I knew he couldn't go without the "deed" being done. We plowed ahead and had achieved a status of 95% of the time accident-free. Well, that would have to do, school was starting and the preschool waiting lists were unbelievably long. There would be no way to pull him out and then get him in again before Kindergarten.

The day before preschool began, our son was going through his typical day...2 settings: "constant motion" or "zombie in front of the TV". In either case, there was little chance of getting his attention unless you had his eyes focused on you. There came a moment, like a scene in a movie, where time stands still and you move in slow motion to thwart a catastrophe. He was racing through our house at full speed, not paying attention (as usual), and tripped headlong into the window sill (2 inches higher and his head would have gone through the window; 1/2 inch lower and the sill would have gone right into his eye.) God has protected this child countless times throughout his life and this was clearly one of those times. He got up screaming in his usual over-the-top fashion, we put some ice on the red mark just below his eye, and I think he may have sat on my lap for a total of 15 minutes before resuming his "fast forward" activities. Breathe a sigh of relief, he's no worse for the wear. Until the next morning...check out the HUGE black eye! I got more than a few knowing looks and raised eyebrows as I walked him into school that first day.

I walked out of the school in tears. Part of it was the normal feelings of a mom saying goodbye to the early childhood of her first child, but part of it was fear. The fear of how the day would go and how my son would respond to the people and situations that would confront him. The fear that this quite possibly could be the step that confirmed some of my suspicions. The suspicions that I might not be a good parent/mother, that my son might not be able to handle school yet, and a teeny tiny nagging thought that there might be a lot of things that my son may struggle with in the future.

Asperger's Theory Does About-face

2009-08-28T13:18:00.000-07:00

AUTISM
TheStar.com | Mind & Mood | Asperger's theory does about-face
May 14, 2009 04:30 AM
Maia Szalavitz
The Daily Beast

A groundbreaking study suggests people with autism-spectrum disorders such as Asperger's do not lack empathy – rather, they feel others' emotions too intensely to cope.

People with Asperger's syndrome, a high functioning form of autism, are often stereotyped as distant loners or robotic geeks. But what if what looks like coldness to the outside world is a response to being overwhelmed by emotion – an excess of empathy, not a lack of it?

This idea resonates with many people suffering from autism-spectrum disorders and their families. It also jibes with the "intense world" theory, a new way of thinking about the nature of autism.

As posited by Henry and Kamila Markram of the Swiss Federal Institute of Technology in Lausanne, the theory suggests that the fundamental problem in autism-spectrum disorders is not a social deficiency but, rather, a hypersensitivity to experience, which includes an overwhelming fear response.

"I can walk into a room and feel what everyone is feeling," Kamila Markram says. "The problem is that it all comes in faster than I can process it. There are those who say autistic people don't feel enough. We're saying exactly the opposite: They feel too much."

Virtually all people with autism spectrum disorder, or ASD, report various types of over-sensitivity and intense fear. The Markrams argue that social difficulties of those with autism spectrum disorders stem from trying to cope with a world where someone has turned the volume on all the senses and feelings up past 10.

If hearing your parents' voices while sitting in your crib felt like listening to Lou Reed's Metal Machine Music on acid, you, too, might prefer to curl in a corner and rock.

But, of course, this sort of withdrawal and self-soothing behaviour – repetitive movements; echoing words or actions; failing to make eye contact – interferes with social development. Without the experience other kids get through ordinary social interactions, children on the spectrum never learn to understand subtle signals.

Phil Schwarz, a software developer, is vice-president of the Asperger's Association of New England and has a child with the condition. He notes that autism is not a unitary condition – "if you've seen one Aspie, you've seen one Aspie," he says, using the colloquial term.

But, he adds, "I think most people with ASD feel emotional empathy and care about the welfare of others very deeply."

So, why do so many people see a lack of empathy as a defining characteristic of autism spectrum disorder?

The problem starts with the complexity of empathy itself. One aspect is simply the ability to see the world from the perspective of another. Another is more emotional – the ability to imagine what the other is feeling and care about their pain as a result.

Autistic children tend to develop the first part of empathy – which is called "theory of mind" – later than other kids. This was established in a classic experiment. Children are asked to watch two puppets, Sally and Anne. Sally takes a marble and places it in a basket, then leaves the stage. While she's gone, Anne takes the marble out and puts it in a box. The children are then asked: Where will Sally look first for her marble when she returns?

Most 4-year-olds know Sally didn't see Anne move the marble, so they get it right. By 10 or 11, children with developmental disabilities who have verbal IQs equivalent to 3-year-olds also get it right. But 80 per cent of autistic children age 10 to 11 guess that Sally will look in the box, because they know that's where the marble is and they don't realize other people don't share all of their knowledge.

Of course, if you don't realize others are seeing and feeling different things, you might well act less caring toward them.

It takes autistic children far longer than children without autism to realize other people have different experiences and perspectives – and the timing of this development varies greatly. But that doesn't mean, once people with autism spectrum disorder do become aware of other people's experience, that they don't care or want to connect.

Schwarz, of the New England Asperger's association, says all the autistic adults he knows over the age of 18 have a better sense of what others know than the Sally/Anne test suggests.

When it comes to not understanding the inner state of minds too different from our own, most people also do a lousy job, Schwarz says. "But the non-autistic majority gets a free pass because, if they assume that the other person's mind works like their own, they have a much better chance of being right."

Thus, when, for example, a child with Asperger's talks incessantly about his intense interests, he isn't deliberately dominating the conversation so much as simply failing to consider that there may be a difference between his interests and those of his peers.

In terms of the caring aspect of empathy, a lively discussion that would seem to support the Markrams' theory appeared on the website for people with autism spectrum disorder called WrongPlanet.net, after a mother wrote to ask whether her empathetic but socially immature daughter could possibly have Asperger's.

"If anything, I struggle with having too much empathy," one person says. "If someone else is upset, I am upset. There were times during school when other people were misbehaving and, if the teacher scolded them, I felt like they were scolding me."

Said another, "I am clueless when it comes to reading subtle cues but I am very empathic. I can walk into a room and feel what everyone is feeling and I think this is actually quite common in AS/autism. The problem is that it all comes in faster than I can process it."

Studies have found that when people are overwhelmed by empathetic feelings, they tend to pull back. When someone else's pain affects you deeply, it can be hard to reach out rather than turn away.

For people with autism spectrum disorder, these empathetic feelings might be so intense that they withdraw in a way that appears cold or uncaring.

"These children are really not unemotional. They do want to interact – it's just difficult for them," Markram says. "It's quite sad, because these are quite capable people. But the world is just too intense, so they have to withdraw."

Maia Szalavitz writes about the intersection of mind, brain and society for publications like Time online, The New York Times, Elle and MSN Health. She is co-author, most recently of Lost Boy, the memoir of Brent Jeffs, a young man raised in Mormon fundamentalist polygamy. She is also senior fellow at the media watchdog organization stats.org.

The journey...G.I. Joe?

2009-08-21T11:13:00.000-07:00

When people kept asking me when I had first suspected that there may have been a "problem" with our son, I had a hard time putting my finger on it. He was in constant motion in utero, but every expectant mom says that. He never slept more that 4 or 5 hours a night even when he was 14 months old, but everyone around me kept saying, "oh yeah, isn't it exhausting that babies don't sleep through the night?" or "oh, he'll grow out of it." When the extent of his naps were 15-20 minutes, 2 or 3 times a day, people started saying that "I needed to be tough and just let him cry himself back to sleep." Since it was my first child and I hadn't grown up with much experience around infants, I thought they must be right. I thought I must be overly sensitive due to my own sleep deprivation.

A glimmer of doubt began to creep in when we hit the 2's and 3's. My son seemed to overreact to everything...happy, sad, hurt, scared...overly emotional. If he had been a girl he would have reigned with the "drama queen" title. He was in constant motion and could not keep his hands to himself..."leap first; ask questions later" seemed to be his mode of operation, although, the questions later rarely came. A friend of mine jokingly told me one day that, out of his Sunday school class, our son was most likely to become a "G.I. Joe." We laughed at the time, but questions were beginning to form in my subconscious mind. What is wrong with me? Why can't I get my child to behave, follow directions, take turns, stop hitting and kicking. I had read every book about parenting that I could get my hands on and found that we were "doing all the right things." But every time I walked out the door to go somewhere with my child, I felt myself holding my breath...waiting for the moment that I would be completely embarrassed and make a quick exit from whatever activity we were engaged in.

Back to School Backpack Guidelines

2009-08-21T07:16:00.000-07:00

BACK-TO-SCHOOL SPAWNS BACKPACK AWARENESS
Published 08/11/2009

Harris County Department of Education Therapy Services,
American Occupational Therapy Association support backpack limits

Students shouldn’t wear a backpack heavier than 15 percent of their body weight, according to the American Occupational Therapy Association. Concern about student health is the thrust behind an annual AOTA campaign being promoted locally by Harris County Department of Education’s Therapy Service.

“Children begin to suffer when they wear a heavy, 20-pound backpack throughout the year,” said Jean Polichino, director of HCDE’s Therapy Services. Per AOTA guidelines, Polichino says a child of 100 pounds shouldn’t bear a load heavier than 15 pounds. Doing so may result in an onset of pain and strain.

HCDE’s therapy specialists work with children and families in schools, homes and daycare centers throughout greater Harris County. Specialists include physical therapists and assistants, occupational therapists and assistants, speech-language pathologists, music therapists and art therapists.

Here are a list of tips for preventing backpack pain and strain per the AOTA:

• Load heaviest items closest to the child’s back, or the back of the pack.
• Arrange books and materials so they don’t slide around in the backpack.
• Shoulder straps so that the pack fits snugly on the child's back. A pack that hangs loosely from the back can pull the child backwards and strain muscles.
• Check what your child carries to school and brings home. Make sure the items are necessary to the day’s activities.
• On days the backpack is too loaded, your child can hand carry a book or other item.
• If the backpack is too heavy, consider using a book bag on wheels if your child’s school allows it.

For questions about backpack safety or HCDE’s Therapy Services, call Polichino at (713) 696-8232.

Article from the Cypress Times (Cypress, TX)
www.thecypresstimes.com

Our personal story

2009-08-15T11:44:00.001-07:00

Many of you have been asking me about our personal journey with Asperger Syndrome. Since it's a long story, I haven't put it all "on paper." With all the recent questions, it may be time to dive in and do just that. I'll be posting a paragraph or 2 at a time to unfold the history of our last 14 years. Parts of this journey have been painful, but I hope that our experiences may help someone else along the way...

"Praise be to the God and Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves have received from God." 2 Corinthians 1:3-4

Come see us!

2009-08-14T23:01:00.000-07:00

Therapy Threads has been asked to be a part of the The Resource Network hosted by the Sumner County Board of Education. This free resource fair will provide an opportunity to meet representatives from over 30 organizations that offer support and expertise in a number of areas for children and families with special needs.

The Resource Network will be held in the Woods Campus Center at Volunteer State Community College (Gallatin, TN) on Thursday, August 20 from 6:00 PM to 8:00 PM. Refreshments will be provided!

Please join us! We'd love to meet you.

In the news...

2009-08-12T20:38:00.000-07:00

Therapy Threads was featured in the Gallatin News Examiner today. You can check out the article at: http://www.tennessean.com/article/20090811/MTCN0408/90811046/1478/MICRO0601/Children+inspire+Gallatin+entrepreneur

OT and Sensory Integration

2009-06-21T06:24:00.000-07:00

Sensory Processing Disorder (SPD), also called Sensory Integration Dysfunction (SID), can be a disability in and of itself, but it also affects children with all kinds of special needs. Working to decrease sensory sentitivity is a large part of the work that Occupational Therapists do.

Sensory Integrative Dysfunction in Young Children
by Linda C. Stephens, MS, OTR/L. FAOTA reprinted with permission from AAHBEI News Exchange, Vol. 2, No. 1, Winter 1997
(note: this article is a reprint. The article is presented as a public service. It was not authored by school staff. Please do not write requesting additional information. Sensory integration is not an area of expertise at the school. We can provide no additional information on this topic.)
For more information see
Sensory Integration
Sensory Integration Dysfunction Links
Sensory Integration Resources
SSEPAC-Sensory Integration Links
Center for the Study of Autism-Sensory Integration
The National Fragile X Foundation - Fragile X Syndrome
The Out-of-Sync Child
Sensory Integration Resource Center Home Page
Sensory Resources
All of us depend on adequate sensory integrative functioning in order to carry out daily tasks in work, play and self-maintenance. Disorders in this domain can greatly influence our ability to function, but also can be so subtle that they easily go unrecognized. Particularly in the young child it is easy to attribute behaviors and reactions to other causes ("He's stubborn, lazy, or doesn't want to do it," or "She's spoiled, shy, or headstrong.") or to consider it within the norms of the wide range of personality and developmental characteristics of young children. However, it is important to identify and address sensory integrative dysfunction to enable the child to function at his or her optimum level and to minimize disruption in family life. This article will explain ways of addressing sensory integrative problems within the context of family life and the child's normal activities.

What is sensory integration?
Sensory integration, simply put, is the ability to take in information through senses (touch, movement, smell, taste, vision, and hearing), to put it together with prior information, memories, and knowledge stored in the brain, and to make a meaningful response. Sensory integration occurs in the central nervous system and is generally thought to take place in the mid-brain and brainstem levels in complex interactions of the portions of the brain responsible for such things as coordination, attention, arousal levels, autonomic functioning, emotions, memory, and higher level cognitive functions. Because of the complexity of the various areas which are dependent upon and interact with each other as well as the child's own personality and environment, it is not possible to have a single list of symptoms which identify sensory integrative dysfunction.

A. Jean Ayres, Ph.D., was an occupational therapist who first researched and described the theories and frame of reference which we now call sensory integration. In her book, Sensory Integration and the Child, Dr. Ayres makes several analogies which describe sensory integration and its dysfunction. She describes sensory information as food for the brain similar to the food which nourishes our physical bodies. Difficulty in processing and organizing sensory information causes dysfunction which can be compared to indigestion which occurs when the digestive tract malfunctions. Another analogy compares the brain to a large city with traffic consisting of the neural impulses. She states: "Good sensory processing enables all the impulses to flow easily and reach their destination quickly. Sensory integrative dysfunction is a sort of `traffic jam' in the brain. Some bits of sensory information get `tied up in traffic,' and certain parts of the brain do not get the sensory information they need to do their jobs." (Ayres, p. 51)

Various characteristics of sensory integrative dysfunction will be discussed under four categories: attention and regulatory problems, sensory defensiveness, activity patterns, and behavior.

Attention and Regulatory Problems
The ability to attend to a task depends on the ability to screen out, or inhibit, nonessential sensory information, background noises, or visual information. The child with sensory integrative dysfunction may frequently respond to or register sensory information without this screening ability and is considered distractible, hyperactive, or uninhibited. These children are always "on the alert" and constantly asking about or orienting to sensory input that others ignore (refrigerator motor, heater fan, distant airplane, etc.). Other children may fail to register unique sensory input and are unresponsive to stimuli. For example, the child may not turn around or respond when her name is called. One parent said that her child was oblivious and unresponsive to a loud noise in the same room but immediately responded when he heard a piece of candy being unwrapped two rooms away.

Children with regulatory disorders often have difficulty establishing appropriate sleeping and eating patterns, are unable to calm or console themselves, and may overreact to environmental stimuli. Georgia DeGangi states that "disorders of regulation appear to be based on problems associated with sensory processing, communicative intent, state control and arousal, and modulation of emotions" (DeGAngi, 1995). The infant or child who is very irritable, difficult to soothe, emotionally labile, and hypersensitive to touch or other sensory input may have regulatory problems.

Sensory Defensiveness
Sensory defensiveness is a sensory integrative disorder characterized by a "fight, flight, or fright" reaction to sensory information most individuals would consider harmless. Tactile defensiveness, or hyper responsiveness to touch, was identified by Dr. Ayers in the 1960's. Since that time researchers have recognized defensiveness in other sensory areas as well. The individual who has sensory defensiveness typically has a highly aroused nervous system which prepares the body for survival, but does not recognize that the input is nonthreatening. Behaviors which can be associated with tactile defensiveness are aggressiveness, avoidance, withdrawal, and intolerance of daily routines. Combing or shampooing hair, cutting fingernails, or brushing teeth can be exhausting and difficult for families of children who react defensively with acting out behaviors or tantrums. Other children may cope by being very rigid and demanding with insistence on certain textures of clothing, cutting all tags and labels out of clothing, or displaying extremely limited choices of food because of intolerance to textures. Social skills can be very limited if the child withdraws or picks fights as a result of unexpected touch.

Auditory defensiveness can occur with negative responses or fears related to sounds and noises. Some children are so fearful of sounds such as vacuum cleaners, lawn mowers, hair dryers, leaf blowers, or sirens that parents must arrange to use appliances when the child is out of earshot. Other children may show intolerance of sounds and noises by clapping their hands over their ears. One child I knew could not tolerate the sound of a flushing toilet, another covered his ears when his preschool class had music.

Visual defensiveness can occur with hypersensitivity to light or avoidance of gaze. Oral-motor defensiveness (tactile defensiveness within the mouth) can cause distress with brushing teeth and dentist visits as well as intolerance to textures or temperatures of food. Children with olfactory defensiveness (intolerance to odors) may gag or be distressed with certain smells which other persons don't notice or don't mind. One child I know could not tolerate going into a deli with his mother because the odors made him feel sick.

Defensiveness in the vestibular area can result in intolerance to movement or unstable surfaces with fearfulness, avoidance, or motion sickness. The child may be afraid to go down steps or to ride an escalator. One child I knew not only would not step up a few inches on my floor mat, but refused to step up a curb, even holding his mother's hand. Each time they came to a curb, the mother either had to carry him or allow him to get on his hands and knees to crawl over the curb. Another child was so sensitive to motion in the car that her family always had to take the back roads avoiding the expressways (rather difficult in an urban area!).

Activity Levels
Young children are, by nature, active. We expect the toddler to be "into things" and the preschooler to be curious, to explore and to play vigorously. We don't expect the young child to have a very long attention span. Characteristics which indicate problems in one child may be perfectly normal in a younger child. Here are some warning signals related to activity levels:

1. The child is disorganized and lacks purpose in his or her activity. This is the child who goes through the room like a tornado. Even though the child may appear to be interested in a toy or object initially, once he gets it he may throw it aside, dump it out of the container, or immediately be distracted by something else. Another characteristic is that the child lacks exploration or manipulation; he may dump objects out of a container or off a shelf without stopping to manipulate, visually examine, or play creatively with them. On the playground the child may run around a lot but does not organize his activity to climb, swing, or explore equipment.

2. The child does not move around or explore the environment. This is the "good" baby or toddler who is content to stay in one place and does not make many demands on his or her caretakers. This child may be content to watch things in his environment although he is physically able to move around and interact. The older child may use good verbal skills to engage the adult in conversation as a way of avoiding manipulating with his hands or actively engaging in activity.

3. The child lacks variety in play activities. Some children become very repetitive or stereotypic in playing with toys. Everything may be flung aside, tapped on a surface, or brought to the mouth. Another child may prefer only visual activities (TV, videos, looking at books) while avoiding visual-motor or manipulative toys (coloring, drawing, clay, construction toys.) Other children may learn one way to interact with a toy or playground equipment without adding variations, creative play, or generalizing to other similar objects. For example, the child may line up toy cars but does not pretend they are going places or experiment with rolling them down an incline.

4. The child appears clumsy, trips easily, has poor balance. The child may experience an excessive number of bumps, bruises, stitches, or broken bones. Sometimes this child seems always to be in a hurry and impulsive, does not "look where he is going." Other children may always be bumping their heads because they lack protective responses and do not "catch themselves" when they begin to fall.

5. The child has difficulty calming himself after exciting physical activity or after becoming upset. After this child "loses it" he cannot be consoled. Tantrums may last for hours, or the child may become so excited after vigorous play that he continues high activity levels long after the event. Some children regularly escalate their activity levels during the day without experiencing "down time" or being able to engage in quiet activity. Dinner time becomes chaotic and the child has extreme difficulty falling asleep at bedtime.

6. The child seeks excessive amounts of vigorous sensory input. Many children like to jump, swing, and spin; but when this is excessive, it may be problematic. The child may spin himself on playground equipment or twirl around a room for prolonged periods without experiencing dizziness. Another child may continually throw himself on the floor, deliberately hurl himself against people and things, or jump excessively.

Behaviors
Sensory integrative dysfunction can adversely affect many areas of a child's development, including emotional and social. Many children become discouraged or develop poor self-concept, especially if they become aware of differences in their function and those of their peers. If a young child has difficulty with motor skills and play activities, it may be hard for him to make friends or to be part of a group. Sensory defensiveness can cause aggressive behaviors or cause the child to be a loner.

Sometimes behavior problems are the first indications that the child may have sensory integrative dysfunction. The child may lack flexibility, be explosive, or have difficulty with transitions such as leaving one place to go to another. The child may show extreme irritability or crying which may seem unexplainable until it is discovered that he is fearful of certain sounds, overwhelmed by visual stimuli, or is intolerant to wrinkles in his socks. Sometimes children are so rigid in their behaviors that families go to extremes to accommodate them in order to maintain peace. The mother who follows the child around with a spoonful of food, begging him to eat, or the parents who allow the child to sleep in their bed because he won't go to sleep otherwise, may be taking care of the short-term problems of getting the child to eat or to sleep without addressing underlying problems.

Conclusion
This article has been an overview of some of the ways sensory integrative problems manifest themselves. Any particular child may show only a few of the characteristics described and some characteristics could be caused by something other than sensory integrative dysfunction. Parents and professionals are advised to look at the pattern of behaviors and the "big picture" of how the problems interfere with the child's function in his or her play, physical and emotional development, and ability to develop independence. Any child who is suspected of having a sensory integrative disorder should be evaluated by a professional (usually an occupational or a physical therapist) who has had additional training in sensory integration evaluation and treatment. Sensory integration "certification" means that the individual has had more than one hundred continuing education hours in theory, test mechanics, and interpretation of test results from the Sensory Integration and Praxis Tests (SIPT). Although such certification assures additional training in this specialty area, there are many licensed professionals who are very competent in the specialty who are not certified.

Resources
Ayers, a. Jean. Sensory Integration and the Child. Los Angeles: Western Psychological Services. 1994.

DeGangi, Georgia A. et al. Infant/Toddler Symptom Checklist: A Screening Tool for Parents. Tucson, AR: Therapy Skill Builders, 1995. (1-800-0763-2306)

Trott, Maryann Colby et al. SenseAbilities: Understanding Sensory Integration. Tucson, AR: Therapy Skill Builders, 1993.

Linda Stephens is an occupational therapist in private practice in Atlanta, Georgia. She specializes in sensory integration and has worked with children for thirty years. Her private practice, Atlanta Children's Therapy, Inc., is located in Atlanta, Georgia.

OT for Cerebral Palsy, Sensory Integration, and Autism -- Part 2

2009-04-23T11:01:00.000-07:00

OT for Cerebral Palsy, Sensory Integration, and Autism

2009-04-23T10:43:00.000-07:00

This is a great video to explain the different parts of an OT program. You will see a variety of things that you may see in a session with your OT but many of these techniques can also be done at home.

Occupational Therapy: Skills for the Job of Living--Handwriting

2009-04-21T19:49:00.000-07:00

Handwriting is a complex process of managing written language by coordinating the eyes, arms, hands, pencil grip, letter formation, and body posture. The development of a child’s handwriting can provide clues to developmental problems that could hinder a child’s learning because teachers depend on written work to measure how well a child is learning.

Occupational therapists can evaluate the underlying components that support a student’s handwriting, such as muscle strength, endurance, coordination, and motor control, and parents can encourage activities at home to support good handwriting skills.

What can an occupational therapist do?
■ Demonstrate proper posture to supports the proper use of the arms, hands, head, and eyes.
■ Measure the level of physical strength and endurance.
■ Analyze fine motor control, such as the ability to hold a writing utensil.
■ Determine visual and perceptual ability that influences a child’s ability to form letter and shapes using a writing utensil.
■ Help develop and evaluate handwriting curriculums and collaborate with teachers on effective strategies.
■ Suggest home activities that promote the development of skills needed in good handwriting.

What can parents and families do?
■ Encourage children to participate in sports and games that could improve visual, motor, and
coordination skills, such as playing ball, jacks, marbles, and outdoor sports.
■ Require children and teens to use silverware when eating to develop hand grip.
■ Provide an activity that exercises the hands, such as cutting pie dough or pizza and using cookie cutters.
■ Encourage writing handwritten letters to grandparents and friends.

Occupational therapists and occupational therapy assistants are trained in helping children with a broad range of issues in addition to the development of handwriting skills, such as proper computer use, proper backpack use and behavioral problems.

Occupational Therapy: Skills for the Job of Living
The American Occupational Therapy Association, Inc.
www.aota.org
Copyright 2001 American Occupational Therapy Association, Inc. All Rights Reserved.
This page may be reproduced and distributed without prior written consent.

Sensory Integration and OT

2009-04-21T19:15:00.000-07:00

Most of us unconsciously learn to combine our senses (sight, sound, smell, touch, taste, balance, body in space) in order to make sense of our environment. Children with autism and sensory integration disorders have trouble learning to do this. Sensory integration therapy is a type of occupational therapy (OT) that places a child in a room specifically designed to stimulate and challenge all of the senses. During the session, the therapist works closely with the child to encourage movement within the room. Sensory integration therapy is driven by four key principles (1):
the child must be able to successfully meet the challenges that are presented through playful activities;
the child adapts her behavior with new and useful strategies in response to the challenges presented;
the child will want to participate because the activities are fun; and
the child's preferences are used to initiate therapeutic experiences within the session.

Sensory integration therapy is based on the assumption that the child is either overstimulated or understimulated by the environment (2). Therefore, the aim of sensory integration therapy is to improve the ability of the brain to process sensory information so that the child will function better in his daily activities (2).

A sensory integration room is designed to make the child want to run into it and play (1). During sensory integration therapy, the child interacts one-on-one with the occupational therapist and performs an activity that combines sensory input with motion (1, 2, 4). Examples of such activities include:
swinging in a hammock (movement through space);
dancing to music (sound);
playing in boxes filled with beans (touch);
crawling through tunnels (touch and movement through space);
hitting swinging balls (eye-hand coordination);
spinning on a chair (balance and vision); and
balancing on a beam (balance).
The child is guided through all of these activities in a way that is stimulating and challenging (1). The focus of sensory integration therapy is helping children with autism and sensory processing disorders combine appropriate movements with input they get from the different senses.
A parent can integrate sensory integration into the home by providing many different opportunities for a child to move in different ways and feel different things. For example, a swing set can be a form of sensory integration therapy, as can a ball pit or a lambskin rug.

On a daily basis, most people experience events that simultaneously stimulate more than one sense (5). We use our multiple senses to take in this varied information, and combine them to give us a clear understanding of the world around us. We learn during childhood how to do this (6). Thus, through childhood experiences we gain the ability to use all of our senses together to plan a response to anything we notice in our environment (5). Children with autism and sensory processing disorders are less capable of this kind of synthesis and therefore they may have trouble responding appropriately to differently stimuli.
Children with autism may also have a difficult time listening when they are preoccupied with looking with at something. This is an example of their difficulty in receiving information via more than one sense simultaneously (5, 7). Physicians who treat children with autism and sensory processing disorders believe that these difficulties are the result of differences between the brains of children with autism and other children (5, 7, 8).

The underlying concepts of sensory integration therapy are based on research in the areas of neuroscience, developmental psychology, occupational therapy, and education (1-3, 9). Research suggests that sensory information received from the environment is critical; interactions between the child and the environment shape the brain and influence learning. Furthermore, research suggests that the brain can change in response to environmental input, and rich sensory experiences can stimulate change in the brain.

While sensory integration therapy is not harmful, some forms of sensory therapy may be uncomfortable for the child. Children with autism and sensory processing disorders can be especially sensitive to certain types of sensory stimulation; the therapist should respond appropriately to each child. Children should be closely monitored for any negative reactions or self-soothing behavior which might indicate the child is feeling uncomfortable (4). True sensory integration therapy, however, should be child-directed, playful, and pleasant for the child (1, 12).

References
1) Schaaf, R.C., and L.J. Miller. 2005. "Occupational therapy using a sensory integrative approach for children with developmental disabilities." Ment.Retard.Dev.Disabil.Res.Rev. 11(2):143-148.
2) Dempsey, I., and P. Foreman. 2001. "A Review of Educational Approaches for Individuals with Autism." International Journal of Disability, Development and Education v48 n1 p103-16 Mar 2001.
3) Marr, D., et al. 2007. "The Effect of Sensory Stories on Targeted Behaviors in Preschool Children with Autism." Phys Occup Ther Pediatr. 27(1):63-79.
4) Baranek, G.T. 2002. "Efficacy of Sensory and Motor Interventions for Children with Autism." Journal of Autism and Developmental Disorders v32 n5 p397-422 Oct 2002.
5) Iarocci, G., and J. McDonald. 2006. "Sensory integration and the perceptual experience of persons with autism." J Autism Dev.Disord. 36(1):77-90.
6) Wallace, M.T., and B.E. Stein. 2006. "Early Experience Determines How the Senses Will Interact." J Neurophysiol.
7) Minshew, N.J., et al. 2004. "Underdevelopment of the postural control system in autism." Neurology. 63(11):2056-2061.
8) Waterhouse, L., et al. 1996. "Neurofunctional mechanisms in autism." Psychol.Rev. 103(3):457-489.
9) Boddaert, N., et al. 2004. "Superior temporal sulcus anatomical abnormalities in childhood autism: a voxel-based morphometry MRI study." Neuroimage. 23(1):364-369.
10) Dawson, G., and R. Watling. 2000. "Interventions to facilitate auditory, visual, and motor integration in autism: a review of the evidence." J Autism Dev.Disord. 30(5):415-421.
11) Ayres, A.J., and L.S. Tickle. 1980. "Hyper-responsivity to touch and vestibular stimuli as a predictor of positive response to sensory integration procedures by autistic children." Am.J Occup.Ther. 34(6):375-381.
12) Case-Smith, J., and H. Miller. 1999. "Occupational therapy with children with pervasive developmental disorders." Am.J Occup.Ther. 53(5):506-513.

Limitations...

2009-04-08T15:00:00.000-07:00

"Never limit yourself because of others' limited imagination; never limit others because of your own limited imagination." --Mae Jemison

Where Can I Turn for Help When My Child Has Sensory Integration Problems?

2009-03-29T17:38:00.000-07:00

Written by Zoe Mailloux, Co-Author of Love, Jean: Inspiration for Families Living with Dysfunction of Sensory Integration.

Although many professionals are now aware of sensory integration disorders, parents still face difficulties in finding qualified help for their children with sensory integration problems. Find out who can help and what professional qualifications are important, when you suspect your child has sensory integration issues.

Parents know their children better than anyone. When a parent feels that something is not right, they are usually correct. If the problem is obvious, like hearing loss or weak muscles, it will usually not be difficult to find out what is wrong and to get the appropriate help. However, when the problem is hard to see or to name and if it is not commonly understood, a parent can flounder for a long time before being able to get the right kind of help.

When parents contact me they often say that they have been concerned about their child for a long time. It is common to hear that they have described their worries to many people and that no one has recognized what the problem might be. Often parents find help by chance. A neighbor might mention that their child is receiving help for difficulties that sound similar to the concerns a mother has about her own child. One mother told me that she typed random phrases such as "afraid of swings" in an Internet search and eventually found help.

Unfortunately, I commonly hear that parents, particularly mothers, have been told that the problem most likely is the result of their parenting style. Over coming feelings of guilt often becomes part of the discover process for parents. Feelings of relief and validation are also common. I cannot count the number of times I have heard, "This is the first time someone has put words to the feelings that I have had about what is going on with my child." My colleagues tell me that they hear similar comments.

While more and more teachers, psychologists, and doctors are recognizing sensory integration dysfunction, most professionals in these fields do not receive much training about these problems. The group of professionals who tend to have the most training in sensory integration theory and practice are occupational therapists. The basic principles of the theory, evaluation, and treatment associated with this approach are taught in all accredited occupational therapy programs. Physical therapists and speech and language pathologists are also likely to have received some basic training in sensory integration concepts. Although introductory information may be taught to the extent that most occupational therapists, many physical and speech and language therapists, and some teachers and psychologists and physicians will be familiar with sensory integration concepts, advanced training is required for a professional to be qualified to evaluate and treat sensory integrative disorders.

Reputable therapists should feel comfortable being asked about the following standard qualifications:
A university degree and a license, registration, or credential in a recognized professional field such as occupational or physical therapy, speech and language pathology, psychology, education or medicine. Sensory integration is an approach applied by these fields, but there is not a separate professional discipline of "sensory integration." Parents should beware of people who call themselves "sensory integration therapists," if they are not a validated member of one of the professions listed above.

Advanced, post-graduate training in specialized course in sensory integration, theory, evaluation and treatment. At least 30 hours of advanced study is usually expected. Therapists should be able to produce a certificate or other documentation of their advanced training.

Clinical experience of at least three to four months under the supervision of an experienced mentor. Therapists should be able to describe the extent of their clinical experience with regard to ages and diagnoses of individual with whom they have worked.

Evidence of ongoing training, education, and experience. Sensory integration is an evolving theory that is updated as new research advances knowledge and influences evaluation and intervention choices. Therapists using this approach should be able to show evidence of ongoing, current learning experiences.

If you suspect that your child may have problems in sensory integration you should mention your concerns to your child's pediatrician and /or teachers. These professionals may be familiar with these kids of problems and be able to help you find resources in your community. Hearing your concerns will also give them an opportunity to share their impressions of your child. However, if they seem unaware of sensory integration dysfunction, or if they tell you to "wait and see," you will probably need to rely on other sources of help.

Finding an occupational therapist in your community with the qualifications listed above is a good place to start. To do this, contact your local pediatric hospital or school district and ask to speak to the occupational therapy department. Even if these agencies do not employ therapists with training in sensory integration, the therapists in those departments are likely to be familiar with the resources in the community.

Zoe Mailloux, MA, OTR, FAOTA is the co-author of Love, Jean: Inspiration for Families Living with Dysfunction of Sensory Integration. Zoe Mailloux worked under Jean Ayres and is well known withint the profession of occupational therapy in the area of sensory integration theory and practice. She is currently the Directory of Advministration at Pediatric Therapy Network, a non-profit children's therapy center serving over 1000 children and their families. Love, Jean: Inspiration for Families Living with Dysfunction of Sensory Integration is unique in presenting formally unpublished letters from Jean Ayres, but also in documenting the struggles of a student with sensory integration disorder over the course of his life. This excerpt from the book is reprinted with permission of the publisher.

Every Special Kid is a Genius

2009-03-24T19:32:00.000-07:00

"Everybody is a genius. But, if you judge a fish by its ability to climb a tree, it will spend it's whole life believing that it is stupid." Albert Einstein

What is OT anyway?

2009-03-15T15:24:00.000-07:00

A new day...a new blog! This will be a place for Therapy Threads to provide OT information and ways you can help your child at home. It is our desire to not only provide OT products, but also practical support and ideas for daily life with a child who has special needs. If you have specific questions, please let us know. We will either answer your question (if we have that information) or seek out that information and share it here for everyone's benefit.

Occupational Therapy...what is it anyway? "Occupational therapy (OT) is skilled treatment that helps individuals achieve independence in all facets of their lives. OT assists people in developing the "skills for the job of living" necessary for independent and satisfying lives. Occupational therapy focuses on enabling people to participate in meaningful and purposeful activities of daily life. An individual's "occupation" is an activity that "occupies" his or her time. For example, a child in grade school has the occupation of learning. An adult may need to learn how to write after a traumatic injury. And a senior may want to continue driving safely in order to stay active in the community. All of these daily life activities are "occupations" and participating in them is vital to maintaining overall health and wellness." (quote from The American Occupational Therapy Association)

Occupational Therapists are highly skilled at figuring out what makes a child happy and motivated. They use this information to tailor the time they spend with that child into something unique and productive. Goals will be set with input from parents and teachers. Often improvement is seen after the very first appointment. A great benefit of sessions with an OT is that a parent can take a variety of ideas home with them to reinforce progress and take the next step toward a goal. OT can be very fun for the child and often looks like playtime to someone unfamiliar with the process. Anything fun, that helps a child make progress, becomes rewarding for everyone involved.

In my next blog, we will be talking about OT and sensory integration.

Until then...
Laurie

http://www.therapythreads.com/