Holiday Behavior Strategies: Preparation is Key!

While the holidays can be a time families look forward to all year long they can also be stressful, especially so for children who have difficulties with executive functioning or sensory processing. Even if you have a typically developing child, holiday gatherings, travel, and changes in the usual routine can be overwhelming for kids. With a little preparation, though, parents can help make holiday activities more manageable and help prevent behavior problems that may result when kids are overstimulated or confused.

Try making a visual schedule or calendar for the holiday season so your child knows what to expect. Depending on your child’s abilities you could use a daily, monthly, or weekly schedule. Make a note on the schedule of whether your child will be in school or at home, and any special activities that will happen that day. Before you leave for an event, go over how long you will be there, and how your kids are expected to behave.

Social Stories can also help prepare children for holiday activities. A social story is a reassuring and easily understandable story tailored to describe a situation, concept, or skill that may be causing difficulty. They can be used to explain the perspectives of others in this situation, as well as expected behavior and responses. You can make a social story about holiday situations with a word document and some pictures, or customize one already available for free online.

Some children may do better practicing unfamiliar events beforehand, like sitting at a table with lots of people, sitting on Santa’s lap, or opening gifts.

Drawing pictures with your child about an unfamiliar activity, like decorating a tree, may help relieve anxiety and overstimulation. You can also get out photos and crafts from last season to help explain activities.

Allow extra time for transitions to and from holiday events, so transitions will not be a problem with your rushed schedule. Try to plan for quiet time breaks, as well, especially if you know your child can become overstimulated. Check in with your child frequently to gauge how he or she is doing, and whether or not they may need a break.

Try slowing the schedule down a little. It can be hard to put a limit on holiday activities, but if you try to keep things to a minimum, the holidays will be much easier on your kids, and on you too!

Making sure kids are well-prepared for holiday activities can help prevent behavior problems and tantrums. It’s not possible to anticipate and prepare for everything that may trigger a tantrum, though. Next time on the Therapy Solutions for Kids blog, we’ll discuss sensory strategies for defusing an unexpected holiday tantrum.

Early Sensory Skills: Activities for Sensory Skills Development

Sensory processing refers to the brain’s ability to receive, interpret, and effectively use information provided by all the senses: vision, hearing, taste, smell, touch, and the detection of movement (vestibular and proprioceptive systems). The ability to process sensations and filter them efficiently is the foundation upon which higher-level skills such as language, vocabulary, social skills, problem-solving, and coordination are built. Therefore, if there is inefficiency in processing sensory information, a child's abilities in higher-level skills are compromised.

There are many fun and easy activities you can do with young children to help them develop early sensory skills that will aid in their later development. This article suggests some basic games and activities that can help stimulate and develop the senses. Some of them you are probably already doing! These activities are best for very young children and children with developmental delays.

Sensory Skill: Movement (Proprioceptive & Vestibular)
Proprioception is the awareness of one’s body and where it is in space. To help develop this awareness in your child, set up an obstacle course of pillows or soft blocks to climb over and around so she can start to develop her awareness of where her body is in space as she moves in different directions. Vestibular awareness refers to the sensation of movement and balance. Holding your child and spinning around a few times with her can help with this sense. Another great way to stimulate vestibular as well as proprioceptive awareness is to swing your baby or toddler back and forth in a blanket, varying the speed and direction of the swinging so he can feel and see the shifts in movement and his postion in space.

Sensory Skill: Vision
When you sit your child on your lap, face-to-face, smiling, talking, singing, making faces, or gently swaying from side to side with her, you will be helping her increase awareness of the sense of vision and developing skills related to vision such as spatial awareness, eye contact, and communication. Try to keep the child’s eye-contact going when you do this, and encourage any attempts she makes to communicate. You can also vary this activity by playing peek-a-boo.

Sensory Skill: Touch
Playing in the bathtub is a fun way to help your child develop his sense of touch. Try using a cup to pour small amounts of the bathwater over your child’s hands or body. Try varying the temperature a bit (make sure to test on yourself first!) and talk to him while you do this, using descriptive words for body parts and temperatures, so he can begin to learn vocaublary for different sensations. You can vary this activity by providing bath toys with different textures. When you dry him off with a towel he will be experiencing another texture, as well as the difference between wet and dry.

Sensory Skill: Hearing
Play a listening game to help your child develop his awareness of the sense of hearing: sit quietly, inside or outside, and try to name the sounds you hear. Use vocabulary words to describe what he might be hearing.

Sensory Skill: Taste & Smell
Mouthing or tasting are amongst the earliest ways infants explore their environment. Use contrasting tastes and smells to raise a child’s awareness of her sense of taste, develop her interest in food, practice feeding skills, and give her an opportunity to express preferences. Offer a small taste of a sweet food (pudding, honey, jam) to smell, lick, or taste, and note her reaction to it. Offer more if she would like. Offer a small drink of water to clear the taste, then offer a small amount of a savory food (peanut butter, cheese, soup) to smell, lick, or taste. Note her reaction to this new taste, then offer a choice between the two. Try contrasting other flavors, like saltly and sour, or bitter and spicy, two different textures, or two different temperatures.

Sources:

Early Sensory Skills, Jackie Cooke (1996).

“Developing and Cultivating Skills Through Sensory Play,“ Danielle Steinberg, pbs.org

Developing Fine Motor and Pre-Writing Skills: 10 Easy Activities

There are many things children do through play that prepare their fingers for handwriting. As they reach 3 years old, children are naturally drawn to activities that require them to use both hands, such as building with Duplo's and Lego's, rolling Play Dough, and stringing beads. All of these activities begin to develop the small muscles in the fingers required for writing. They also help develop ‘arches’ in the palms of the hands. These arches allow the palms to ‘round,’ allowing the fingertips to be used for holding pencils and crayons. They also require the two sides of the hands – the thumb and index finger side and the last three fingers side – to begin to work separately for tasks like using scissors.

1. Hide small objects in Play Dough for your child to find; this will require the use of fingertips.

2. Play with magnets on the refrigerator. Things on a vertical surface vs. horizontal surface require the hands to work in adifferent way.

3. Play with eye droppers. You can use colored water to drip onto coffee filters. Encouraging your child to try ‘just one drop’ will help increase finger control.

4.Use tongs to pick up small items. Many stores offer plastic chopsticks that are connected at the top, perfect for this activity.

5. Coloring allows children to begin to grade the small muscles in their fingers by the starting and stopping required to ‘stay within the lines.’

6. Legos and Duplos require fingertip use to put them together and help to increase strength by taking them apart.

7. String beads, macaroni, or round cereal such as Cheerios onto strands of string or yarn. Younger children may be more successful starting to string with pipe cleaners.

8. Lite Brites require very small fingertip precision.

9. Begin using card games like Old Maid to challenge fingers to hold multiple cards at one time.

10. Learn how to snap fingers.

These may not be new or different activities to you but maybe you will see your child doing one of these things and realize that there is a functional reason for their play.

If you have a child over 5 years of age who is having difficulty with using a proper grip for writing, the above activities may help develop the muscle strength and manipulation skills to change their grip.

Child Passenger Safety Week

This week (9/15/13-9/21/13) is Child Passenger Safety Week. Car crashes are the leading cause of death for children in the United States. The best thing you can do to help protect your child in the event of a car crash is to put him or her in a safety seat that is right for his or her age, weight, and height, and that is properly installed in the back seat of the car.

Children aged 1 through 3 should be kept in a rear-facing car seat as long as possible, until he or she reaches the maximum height and/or weight limits. Convertible seats, which have higher weight and height limits, can be used in the rear-facing position and then converted to the forward-facing position once children outgrow the rear-facing seat.  Your child is ready for a forward-facing seat with a harness, still in the back seat of the car, when he or she reaches the weight or height limitations specified by the manufacturer for your rear-facing seat. They should stay in the forward-facing seat with a five-point harness until they outgrow the weight and height limits specified by the manufacturer. When your child exceeds the size limits on his forward-facing seat he is ready to use the car’s seat belt, but must still sit in a belt-positioning booster seat so that the seat belt is secured properly. The safety belt should be across the chest and shoulder and across the top of the thighs, and the back seat of the car is still the safest. Typically children are able to transition to a regular car seat belt when they are approximately age 8 or 4'9" in height.

A common mistake in the use of child car seats is fitting the harness too loosely. The harness should be snug enough that you cannot pinch any extra material on the child's collarbone. The straps should be at or above the shoulder for forward-facing seats and at or below the shoulder for rear-facing seats.

Make sure car seats are properly installed by following the manufacturer's instructions carefully. Most vehicles made after 2002 have lower anchors that are part of the LATCH system (Lower Anchors and Tethers for Children), to which car seats may be attached. These lower anchors have a weight limit of around 40 to 48 pounds, depending on the vehicle. Once your child has reached the weight limit, the car seat should be installed using the seat belt rather than the lower anchors. Be sure to check your vehicle's owner's manual for weight limits on the lower anchors. Once the seat is installed, check to make sure that it can't move more than an inch from side to side along the belt or lower anchor. To ensure you've installed the car seat correctly, have it inspected by a certified child passenger safety technician.

If your child has special needs, choosing the correct seat and having it properly fitted can sometimes be more complicated. Often conventional car seats (such as those described above) are suitable for children with special needs, but not every car seat is suitable for every child. There are many different special needs car seats and seating adaptations, depending on the particular needs of your child. Here are a few ideas:

A conventional car seat (such as those described above) may be appropriate for your child, as long as he or she does not try to unfasten the restraint. Children with developmental disabilities who have impulsive behaviors can be distracting or dangerous in a moving car, especially if they try to escape their car seats. You might also consider using an upright vest such as those made by E-Z On. There are various models that can have either front or back closures, to keep children with behavioral problems from unfastening their restraints in the car.

There are also several options for children with low muscle tone or poor head control who need extra postural support or must travel in a reclined position. Infants who must lie flat (often due to prematurity), can be secured in an infant car bed such as Angel Guard. E-Z on also makes a modified belt that can secure an older child who needs to lie down in the car, as may be the case if he or she has been placed in a hip spica cast or HALO vest. There are many manufacturers who make car seats that provide extra postural support or head support, with many different positioning tool options.

Our occupational therapist Michelle Nigl-Chang CPST is a Certified National Car-seat Technician with enhanced training for special needs seating, and can help with questions you might have about choosing the right seat for your child and having it properly installed. The National Highway Traffic Safety Administration and the Safe Kids Coalition also offer car safety seat checks, visit their websites for more information about events in your area.

Further resources:

 www.nhtsa.dot.gov

www.aap.org

www.safercar.gov

www.preventinjury.org

www.safekids.org

Back to School Transition Tips

The start of the school year can be full of anticipation and excitement for kids of all ages. However, the multitude of changes, expectations, and challenges involved can also be a source of stress for many kids. If your child is just entering school, transitioning between schools, or simply needs more support as he starts the new school year, taking time for preparation may help reduce start-of-year anxiety.  If your child is:

Starting school for the first time

1.       Visit the school ahead of time. This may be during a scheduled open house time when you are able to walk through the school and meet the teacher. It may be helpful to visit not only the classroom, but also the library, cafeteria, and bathroom. Talk with your child about what may happen there, sounds she may hear, and what he may see. If the school is not open for exploration, you can still visit the outside, walk the perimeter, and talk about what’s inside.

2.       Play on the school playground so your child can become familiar with the playground equipment. Take a sibling or friend so that your child can learn to use the equipment interactively rather that only in solitary exploration. You can discuss common safety rules to help your child be aware that there may be ways to use the equipment that are not allowed and explain why.

3.       At least a week or two before the transition to school, start implementing school time routines. For example, if your child has become accustomed to going to bed and waking up later, start the transition to the new sleep schedule gradually, possibly 10 minutes at a time. Allow enough time for your child’s rhythm to adjust to help minimize morning grogginess by the start of the school year. And, if you child has become used to getting dressed and ready for the day on an extended, leisurely timeline, you can plan more morning activities that require completing these tasks more efficiently.

4.       Shopping for new school supplies can be fun and can help get your child excited to start school, so take her school supply shopping with you and let her pick out some of the supplies. You can even begin to integrate back-to-school skills of reading, writing, and using the eyes by having your child help make a numbered shopping list by writing or drawing the items. He can help cross items off the list and scan shelves for what’s next.

5.       If your child generally avoids seated tabletop tasks during the summer, you many want to set aside a time each day to reintroduce a seated or fine motor task. You can try to keep it fun and summer related – for example, writing or drawing daily activities, practicing letters and numbers in sidewalk chalk or writing in dirt or sand, or adding a tabletop task into an obstacle course.

6.       If your child is a movement-seeker who has been enjoying a lot of outdoor play over the summer, keep in mind that he will likely come home “hungry” for some movement. You can try to work movement – even if only 10 minutes – into the morning routine and set aside time after school for at least an hour.

Older and moving to a new school or up to middle school or high school:

1.       Help your child set up an organization system so he can manage the academic demands of his new school.  Many schools give out planners, so help him maintain his planner and periodically check his backpack to make sure it is organized and he has all the books and supplies he needs for class. Some teachers have their own page on the school website, if your child’s teacher/s has/ have a page make sure he checks for homework updates.

2.       Shopping for new school clothes can be a fun way to help kids get excited about the new school year. Let your child pick out a couple of outfits that she will feel confident in and be excited to wear to school.

3.       Find out before the school year starts about whether there are electives, sports, and after-school activities that your child may be interested in signing up for.

4.       Ask the principal if you can walk the halls of the new school with your child, find out what his schedule is going to be beforehand if possible and map the route she will take from classroom to classroom

5.       If your child will have a locker, help him practice unlocking it on a dial locker or key lock

6.       Make sure to start re-establishing earlier bedtimes and wake-up routine a few weeks before school starts, especially if you child has gotten used to summertime rules of staying up late and sleeping in. You could try to set appointments or activities in the morning so there will be a reason to have to get up and get ready earlier than usual.

7.       Reassure your child that all the adults in the school are there to help her, she doesn’t have to be afraid to ask for help

Hot Days, Cool Play: 10 Ideas for Cool Summer Fun

Ice Tunnels

You'll need:

Large block of ice

Squirt guns or squirt bottles

Salt

Water

Food coloring (optional)

Mix water with salt and a few drops of food coloring if desired. Fill the squirt guns/bottles with salt water. Place the block of ice outside on a tarp or on the grass. Use the squirt guns on the ice block; the salt in the water will make fun holes and trails through the ice. For a variation, use paint brushes to ‘paint’ the ice block using water colors or powdered Kool Aid mixed with rock salt.

Driveway Painting

You'll need:

Paint brushes or paint rollers

Bucket of water

Let your kids use their imaginations to ‘paint’ the driveway with water.

Run through the Sprinklers or hose - Classic!

Water Balloons! Also Classic!

Water Pipes

You'll need:

Various sizes of PVC pipe, elbow and T pieces

Water hose

Have kids put the pipe pieces together and let the water flow through, (younger children may need some assistance).

Water Fight

Squirt eachother with squirt guns, squirt bottles (flexible water bottles, or from containers that mustard or catsup come in) and/or spray bottles.

Skating Rink

Make Colored Ice cubes and let them ‘skate' on foil rivers and lakes. (if you have fun shaped ice cube trays, all the better!

Fruit Salad

You'll need:

Cookie tray

Various fruit (oranges, melons, grapes etc.)

Melon scoop, child safe knives, other kitchen gadgets of choice

Plastic shower curtain or oil cloth

Be ready for this play to be messy! Set up your oil cloth or shower curtain underneath your play surface to catch the drips. Allow your children to explore the fruit, using kitchen gadgets if they want. Squeeze the oranges into cups for juice. Cut the melon, use the melon baller for various fruit. If your kids don’t get carried away, you may have a fruit salad for dinner.

Frozen Sidewalk Chalk

You'll need:

Ice cube trays, muffin tins, or popsicle molds

Corn starch

Water

Food coloring or kool aid

Mix the corn starch and water in a 2 to 1 ratio, add coloring, divide into ice trays, muffin tins, popsicle molds, or any other fun-shaped holder, and freeze. When they are frozen, take them out of the trays and use them to draw on the sidewalk or driveway.

Icebergs

You can never go wrong with any kind of ice and water play. Combining the two is even better. Freeze ice in various sized/shaped containers; once frozen place in larger bin or bucket filled with water. Children may want to float cars or plastic animals on the ‘icebergs’ and explore how the ice can’t sink even if you push it to the bottom. For older children, let them figure out how to get the ice out of the containers by providing them with warm water. They can also experiment with the melting temperature of sidewalks, patios, etc.

Giant Bubble Creation

Ingredients:

• 1 cup light corn syrup
• 2 cups dishwashing soap
• 6 cups of water

Directions:

1. In a large bowl, combine water and corn syrup together
2. Add dishwashing soap slowly, mixing well 

Note: We like to stand in a kiddie pool and create a human bubble! While child is standing in the center of the pool, place a hula hoop around their feet. Soak the hoop well, and slowly raise it over the child’s head.