Wearing Sensory Strategies

retrieved from amazon.com

Receiving proprioceptive input throughout the day is important for children who seek sensory input.  Sensory breaks are an important part of their day to assist with regulation so they can function in whatever situation they may be a part of.  That being said, it may not always be possible to get in the needed sensory break.  Here are some different options that may help them meet their sensory needs throughout the day:

Hats: Tighter caps or hats can provide input to a child’s head throughout the day. This is especially beneficial for prepping those kids that have difficulties tolerating hair cuts.

Tighter clothing: Tighter shirts, such as Under Armor can provide some input and comfort throughout the day. These can be worn under clothing if needed as well.

Wrist Fidgets: A variety of bracelets can be bought or made to be used as fidgets in order to help maintain attention. Rubber bands, thera tube, thera bands, Velcro, beads, hair elastics, etc. could all be used.

Chewy necklaces: Great for those kids that come home with drenched shirts from chewing on them all day.

Sunglasses: For those visually sensitive kids with sunlight and lighting in rooms.

Puff paint pick: Some kids have the urge to pick at things throughout the day, whether it be themselves or items. Buying some cheap t-shirts and decorating them with puff paint can be a great alternative strategy. This way they’re picking at their shirt all day instead, as long as you don’t mind finding trails of puff paint.

Self Regulation Reminders: Some kids need reminders of when their regulation levels start raising in certain situation or going the other way and getting extremely low. Verbal cues don’t always work, especially in busier areas where there may be a lot of stimulus to become overwhelmed by. Visual reminders can help with this. Make a key chain out of tiny laminated visuals to attach to your child’s belt loop, bracelet or backpack. This way it’s with them and easy to refer to when they need a regulatory strategy and it can be their choice.

 

OT Month Handouts

In honor of OT month we decided to create a few handouts for the school districts we work with.  I made them into photo format so that I could share them here but please let me know if you would like the PDF format and I will send them to you.  Happy OT Month!

 

 

Marbles and Water

I was perusing Facebook the other day and I saw my friend post that she put some marbles in her son’s bath and it resulted in hours (ok maybe an exaggeration but probably lots) of fun.  I loved it as soon as I saw it and in fact told her I would probably use it for a blog idea.  She said that she had gotten the idea for the marbles from one of my previous blog posts (I love when life happens like that).

If you are doing this you need to make sure you are supervising the marble and tub time with your kids.  Just think of the sensory input they are getting.  They can feel around for the marbles with their hands or their toes (as mentioned in my post).  They can try to pick up as many as they can or just one at a time.  You could also have funnels or other containers that they can practice putting them into and then pouring them out of.  You can use different colors and have them search for the colors and sort them, or have them count a certain number of marbles and see if the can do it faster with their hands or their feet or their right or their left.

Who else has used marbles in the tub and what did you notice in the process?

Play This, Not That

I am so excited to have Dana from Embrace Your Chaos guest posting here today!  She is a mom and an occupational therapist and has some amazing ideas and great things to share so make sure you check her out at Embrace Your Chaos.  I hope you enjoy her post here as much as I did! (PS – I included the photos)

Just as there are better choices for the foods that we eat, there are also better choices for the types of things our kids play.  Some salad dressings are better for us than others, some brands of chips are better than others, and even some fast food burgers are better than others.  In just the same way, some board games are better for development of your child’s skills, some organized sports are better for our kid’s gross motor coordination, and even some video games benefit our kids more than others do.

As adults with tons of responsibility and long lists of “to dos,” we tend to forget about why play is so important for kids.  Some of us get caught up in running errands and in the things we have to get done while some of us tend to over-schedule our kids, both resulting in less time to engage in play with our children.  Play is a vital part of a child’s life for many reasons.  It develops creativity and social skills.  It provides a natural context for the child to learn and problem-solve.  It motivates kids to challenge their gross and fine motor skills.  The list could go on and on.  While it is our responsibility as adults to go to work, pay the bills, and clean the house, it is a child’s primary responsibility to learn and grow through play (while also helping to clean the house from time to time).

It is even more important in our current society that we, as parents, encourage our kids to play.  With growing expectations at school, entailing more time at the table and more homework, and with the growing fascination of electronics, our kids are engaging in play less and less.

With all types of play, including electronics, there are some choices that are better for encouraging development of our kids’ skills than others.  When thinking about play, consider these factors:

• What are the sensory experiences?  How many sensory systems does the activity incorporate?  Does it get the child moving, exploring, and touching?  Also consider if the activity is too over-stimulating, which many video games tend to be.
• What are the physical components?  Does the activity challenge the child’s coordination, balance, strength, and/or endurance?
• What are the social opportunities?   Does the play activity provide opportunities for turn-taking, sharing, group problem-solving, or conflict resolution?
• What are the cognitive aspects?   What are the opportunities for problem-solving, for following multi-step directions, for learning to sequence, and for learning other concepts and ideas?
• What are the fine motor and visual motor components?  Does the activity work the small muscles of the hands?  Does it develop the manipulation skills needed for a good pencil grasp? Does it encourage the eye-hand coordination skills needed for handwriting development?  Does it improve the fine motor skills needed to manipulate fasteners, tools, and other small objects?

Some of these components may be more important for some kids than others.  Some children may need more opportunities to build their gross motor skills while other kids may be struggling more with their social skills.  It is ALWAYS important to give a child opportunities to create and choose his or her own play activities; but, there are also times when it is appropriate to provide direction to ensure their play tasks target the areas that will benefit them.  Take video games for instance.  The Wii will provide a greater challenge to your child’s coordination and gross motor development than the X-Box.  “Mother May I” may engage more cognitive and sensory-motor skills than “Tag.”  And gymnastics may provide more calming and organizing sensory input for your child than soccer.

Most of all, don’t forget the importance of all types of play.  And remember that play is one of the best ways to foster your child’s development and target the skills your child needs.  When thinking about how to best encourage your child’s skills through play, remember these different components to find those activities that provide your child with the “just right” experiences and challenges!

Be sure to check out Embrace Your Chaos’ “101 Ways to Play” series to find great play activities and learn more about how play can foster your child’s development!

Postural Control – How the Systems Work Together

Postural control is a term used to describe the way our central nervous system regulates sensory information from other systems in order to produce adequate motor output or muscle activity to maintain a controlled, upright posture. The visual, vestibular, and somatosensory systems are the main sensory systems involved in postural control.

The visual system contributes to postural control by delivering information from the retina to different areas in the brain that allow for object identification and movement control.  Therefore, if your child has a visual impairment, it may be affecting their ability to control their posture and balance especially during movement.

The vestibular system, which consists of organs located in the inner ear, contributes by interpreting changes in movement, direction and velocity or speed of movements. This information is sent to the brain stem, which then creates a response that allows your postural muscles to activate and increases your body awareness.  The vestibular system can be affected in children with various syndromes and disabilities.

The somatosensory system contributes by relaying information about body position to the brain, allowing it to activate the appropriate motor response or movement.  Specific receptors or gauges called proprioceptors are located in our muscles, tendons, and joints.  These are the receptors that are able to tell our brain whether our knee is bent or straight, whether we are bearing weight or not, and which muscles are contracting and which are relaxing at any moment. Inadequate somatosensation will affect postural control as well.

So you can see that all three of these systems play an important role in maintaining postural control and balance.  To ensure proper postural control, the sensory information from these three systems must be regulated by the central nervous system in order to produce an appropriate motor response.  So what does proper postural control look like? This is when an individual is able to engage in various static and dynamic activities, such as sitting, standing, kneeling, quadruped, crawling, walking, and running with the ability to contract the appropriate muscles required for a controlled midline posture, as well as the ability to make small adjustments in response to changes in position and movement, without the use of compensatory motions. If even one of the mentioned systems is not working the way it is supposed to it can affect postural control and balance.  However, when one system is affected the other two can be trained to compensate.  If more than one system is affected in combination with central nervous system involvement postural control will be more greatly affected.  Talk with your therapist for ways to assist your child achieve improved postural control.

Questions about Oral Motor Input and their Answers

Here is an article written by one of our OT’s that I thought would be great to share!

Why is my child always putting things in his or her mouth?

When a child puts something in his mouth, he or she may be seeking oral motor input, which basically includes anything that gives the child sensory input to the mouth and may result in a motor behavior such as sucking or chewing. In short, oral motor input is organizing, meaning that it provides us with sensory input that elicits motor behaviors that help us calm down and focus. This is true not only for infants and children, but across the lifespan. In fact, before babies are born, they develop a sucking reflex that will allow them to feed and get nourishment. Thus, from the early stages of life, we learn that getting input through our mouths is a way to satisfy our more basic needs (i.e. nourishment) so that we can focus on more complex needs (e.g. learning from our environment, engaging in social interaction). Even older kids and grown-ups sometimes continue to seek oral motor input- think about chewing gum, biting nails, snacking “just because” or chewing on a straw or pen.

What’s the big deal?

Seeking oral motor input can become problematic once children move beyond the toddler stage, as it becomes socially inappropriate and of course potentially unsafe for them to be indiscriminately putting things in their mouths. Children may develop maladaptive patterns such as overeating, biting other children, or mouthing objects that are potential choking hazards.

What can I do about it?

We can use behavioral strategies to “teach” older children not to put toys or other inedible things in their mouths; however this may not change their basic need or craving for it. This is why we shouldn’t just ignore it- it certainly won’t do kids any good in the long run, particularly in the social arena, to allow them to mouth toys that are shared by other kids in the classroom, chew on their sleeves, bite their siblings during horseplay, or chew the ends of their pencils to bits. What we can do in these cases is provide alternatives or preparatory strategies to meet the child’s oral motor needs (see list below). This means either anticipating the need and providing oral motor options ahead of time, or having alternatives on hand to replace the inappropriate object/behavior.

What are safe/appropriate ways to provide my child with oral motor input?

• Use an electronic/vibrating toothbrush in the morning before school
• Chew foods that are crunchy like carrots or pretzels, chewy like taffy or peanut butter, sour like citrus fruits, or icy cold like a popsicle
• Drink something sour like water flavored with lemon juice (for more input, use a narrower straw)
• Use a thick straw to eat yogurt, pudding, or jello
• Play with whistles, harmonicas, blow bubbles, or blow up balloons
• Use a “chewy” or a vibrating teether

Remember, children should be supervised during oral motor activities to make sure they are using these tools safely!

Tactile Letters

     

One of our recent projects at work was to make tactile letters.  Our therapists used various tactile surfaces such as duct tape, felt, cardboard, bumpy paper, glitter paper, denim and any other paper/material we could find that would provide different tactile input.  This allows the child to trace letters and get different tactile input while they are tracing.  Besides the practice of tracing the letter it also gives their body different input to assist with their learning of how to motor plan letter writing.  To provide even more input they made the tactile surface that formed the letter a distinct and different color from the border so that they could have assistance with visual distinction as well.

Some ways to use these tools other than just having the child practice tracing the letters is to play some guessing games.  You can have the child close their eyes while you trace their finger over the letter and see if they can guess what it is.  Or, you can put the letters under a sheet or cover and have the child reach under and see if they can figure out the letter just by feel.

What other ways can you think of to play with tactile letters?

 

- fun to play tactile games. Have the child close their eyes and take their finger to trace the letter and have them guess what letter it is….. Or place some cards under a blanket or sheet and see if the child can reach under and feel the letter to guess what it is before pulling it out.

Should We Wrap Kids in Bubble Wrap?

I know the trampolines they are talking about in the article are the outdoor ones but I don’t have a picture of one of those!

I recently read an article on Huffington Post about a new statement from the American Academy of Pediatrics (AAP) stating that kids should not jump on trampoline’s because its not safe.  Now I am sure they have looked at the numbers and seen how many injuries have occurred (its actually down in 2009 from 2004 according to the article) but have they looked at the other factors?  How many of those injuries were on a trampoline that was being used correctly?  How many had multiple kids on the trampoline, maybe even big and little kids together?  How many had the proper safety equipment that was recommended?  All of those factors can influence the information.

I’m not saying that there is no risk for injury if kids are being supervised and the equipment is being used properly but the risk most likely decreases.  (I hate to say it but as a child I hurt myself plenty of times when playing while my feet were planted on the ground)  When used properly trampolines can provide kids with cardiovascular exercise, strengthening for their muscles, sensory input, and the ability to explore movement.  With all the complaints of obesity in our youth and their overall sedentary lifestyle why take away something that when used properly can be fun and a great way for exercise?

I have talked about this before but I thought this article brought up an opportunity to reiterate the need for kids to have a chance to get sensory exploration and movement in their environment while engaging in active play.  How many school playgrounds have swings these days?  Or when was the last time you saw a merry-go-round on a playground.

Safety is extremely important but it is also important to let kids play and explore.  With proper supervision and use many ‘dangerous’ activities can actually have much lower risk.  (I made a similar point about the Bumbo chair recall)

What are your thoughts on this topic?

Lycra Tunnel

Our newest toy at work is a lycra tunnel.  One of our OT’s had been talking about wanting one so I finally was able to buy her some lycra and she was able to make one for us.  Of course we all needed to try it out ourselves and let me tell you, its hard work!  Basically a lycra tunnel can be used to provide a kiddo with increased proprioceptive input, work on motor planning and provide them with a core workout.  To make it more challenging you can put a ball in and have them push it through.  The larger the ball, the harder it is.

In terms of motor planning it is challenging to figure out how to move when you are receiving input from all sides which is what this tunnel does.  It provides proprioceptive input all around you as you move through.  I made it about halfway through before I needed to lie down and rest!  The larger the child is the harder it will be also.

When a kiddo is using it you can pull on the back of it so they can advance their legs easier.  In addition, to make it more taut you can have someone pulling from the front as well, or just being at the other end to show the kiddo where the end of the tunnel is.

What else do you use a lycra tunnel for?

Gross Motor Ideas for the Park

Now that nice weather is upon us its time to get outside and play with the kids!  Parks are a great place for kids to effectively ‘burn off’ their energy while working on gross motor skills and socialization.  Here are some of the great things about parks:

• There are other kids around to play with.  They may not even know them but if they are sitting next to each other playing in the sand conversations can start up and they make a new friend.  For kids that need to practice social skills there are lots of opportunities to encourage play and socializing.
• Kids can climb.  There are climbing opportunities for kids of almost every level.  There are usually changes in height on the ground that little ones can practice climbing up and down.  The stairs that go up and down the play structures offer opportunities for walking or crawling up and down stairs.  Ladders come in all shapes and sizes with different patterns that offer opportunities for motor planning and problem solving.  Also they let kids work on climbing down which can offer its own challenges.  Lastly there are usually climbing walls, fake climbing rocks, chain link nets to climb or arches to go up.
• Lots of different surfaces to walk or run on to practice balance.  Sand, grass, tan bark, wiggly bridges are just a few of the surfaces that can provide opportunities for challenging balance.  If you take kids shoes off these same surfaces provide great sensory input opportunities.
• Slides can work on core when kids are learning to go down sitting up, they provide vestibular input, work on depth perception and awareness of height as well as different sensory input depending on if it is straight, curved, steep, in a tunnel, etc.  And if its okay at the park kids can practice climbing up slides (one of my favorite things to do when I was little).
• Swings are a great place to get vestibular input as well as work on head and trunk control.  If kids are old enough to start self propelling its also a great core workout and opportunity for motor planning and coordinated movement as they figure out how to lean back and bring their legs up and then pull themselves forward while bending their knees all while timing it with the movement of the swing.  Another one of my favorite activities as a kid was to see how high I could swing and then jump off.  We had contests to see who could go the furthest!  You may want to have them practice that on a smaller scale first.
• Lots of space can be found at parks which is great for running races, games of tag, riding bikes, throwing and catching balls, soccer, frisbees, kites.  All of these activities are great for gross motor development.
• I also forgot the little ride on toys that bounce back and forth which are fun and provide sensory input as well as problem solving for climbing on and off, and core strength to keep it moving!
• I almost forgot monkey bars.  This is great for upper extremity and core strength.  You can practice having kids hold on to one bar with both hands or stagger their hands across two different bars.  Make sure you change which hand they are leading with.  And, you can help them learn to traverse the monkey bars.  A great way to work on visual attention with a task as well.

What are some of your favorite activities to do at the park?