Go Play!

Question: I keep reading about how play is important, but why? It seems to me like my kids and I have so many better things to do, and I run out of ideas for playtime.

Your question comes at a perfect time, with the American Academy of Pediatrics (AAP) recently releasing a clinical report that concludes with a recommendation that pediatricians prescribe play for/with children in their first two years of life. Doctors prescribing play! Imagine that! It certainly validates play’s importance and will help children and their parents to develop playfulness! If it’s being prescribed for infants and young toddlers, what about the rest of us? We all need play in our lives. When we come to recognize its value to our minds, bodies, emotions and interactions, perhaps we’ll all do a better of finding playtime for our children and ourselves. Though we may need to think of the doctor telling us to do it to rationalize spending time playing, play, pure and simple, is ideally based on intrinsic motivation. We play because, from the inside, it feels good to be engaged in activity for the enjoyment, challenge, and/or involvement in “doing”, or in the process itself.

What is play and why is it important?
Play is one of those things that is hard to define, yet it’s said to be a primary occupation of childhood (lets keep remembering that adults need it too!), whether playing with parents or others, or independently. Play is intrinsically motivating activity in which an individual engages for the sake of engaging, rather than for a specific practical purpose or a specific outcome (for example, the fun and problem solving involved with building a castle, as opposed to building a castle because somebody assigned the task). It’s a way of amusing oneself, or participating in interesting and enjoyable action with others, all while naturally stimulating the brain & body and developmental skills (sensory-motor, language, cognitive, emotional, social, self-help) and affecting our biology through the lifespan. The AAP clinical report is interesting, informative, and comprehensive. Click here for the full report.

Dr. Stuart Brown, a play researcher and founder of the National Institute for Play, helps us understand the neuroscience of play and its solid evolutionary importance, while explaining its critical importance in our lives in his 2010 talk as the Aspen Ideas Festival, and in this YouTube video, Play is More than Fun, It’s Vital. He has also written an enlightening book, Play: How it Shapes the Brain, Opens the Imagination and Invigorates the Soul, which will also help you understand play’s importance.

Play personalities
What kind of player is your child? How about you, yourself? According to Dr. Brown, we each have our own “play personality” that is likely to be one, or perhaps a combination, of these seven types:
artist/creator, who plays as he/she creates
collector, who enjoys acquiring and having the most interesting collection of things or experiences that fascinate him/her
competitor, who plays by way of creating games, by him/herself or with others, and plays to win
director, who plays through organizing activities and experiences, for him/herself and others
explorer, whose play involves discovery, be it physical, emotional or mental
joker, who loves silliness and to engage in nonsense through play
kinesthete, who loves to move, and thinks and feels best when moving
storyteller, whose play focuses on imagination such as telling stories, acting, writing, cartooning & drawing, engaging with others’ products of their imagination.

Observing your child in play (and thinking about yourself and how you play), will give you an awareness of what he/she finds amusing. We as parents, teacher, therapists, and players can honor one’s primary play personality and indulge in activities associated with it, be aware of play compatibilities, and help shape “well-rounded play personalities.”

Play isn’t always easy
Many of us have experienced challenges in play; they’re often part of the play process. Yet for many of the children we work with, the challenges surpass what are considered typical, and are related to underlying limitations or liabilities in areas including sensory processing, motor control, coordination and/or planning, language, cognitive ability, emotion, and sociability, and/or are perhaps related to bio/medical factors, or a tendency for repetitive, inflexible behaviors. Many of the children we work with either do not or cannot play independently; for many of them engaging in play with an adult is difficult. These children are “play deprived” and play deprivation in not good for them or their brains. If your child happens to fall into that category, it’s no wonder you find coming up with play ideas difficult! It, in fact, is! That’s where your therapist comes in. Believe it or not, we’ve all taken courses in play, and creating and engaging in playful experiences is part of our training and the effectiveness of what we do. If your child is currently in therapy, talk with your therapist about how his/her problems are affecting his/her ability to play, both independently and with others. Find out about play development and the different types of play, and get ideas to get started with bringing play and playfulness into home and school for your child (and you!). The following resources are among favorites for sparking ideas for play:

Playful Parenting by Lawrence J. Cohen
A Moving Child is a Learning Child by Gill Cornell and Sheryl McCarthy
The Art of Roughhousing by Anthony T. DeBenedet and Lawrence J. Cohen

Be it games, physical activities, creating, fantasy, outdoor (or indoor) exploration, ideally there’ll come a time when the play ideas won’t have to come from you, they’ll come from your child. You’ll find him/her playing in both familiar and new ways, or you’ll be able to say “Go play” and he/she will do just that!

–Sheila Allen
September 2018

Learning Through Movement – Movement Exploration 1 (ME1)

Therapists know the value of movement and recognize its contribution to both wellbeing and remediation. Ongoing learning about movement and its relationship to various functions is a part of continuing education for us all. Occupational therapist, Liz Duffy, has a particular interest in Educational Kinesiology, the study of movement and its relationship to learning. She has been taking Educational Kinesiology (Edu-K) courses in Brain Gym, Edu-K’s fundamental program since 2009. In July 2018 Liz attended a four-day experiential class, Movement Exploration 1 (ME1), taught by educator and long-time Brain Gym faculty member Carol Ann Erickson. Here’s what she had to say about it- ME 1 was based on active exploration as a means of learning! No sitting for extended periods of listening and note-taking in this course! Each day involved in depth experiences of developmental movement patterns and underlying reflexes that begin in utero and develop through adulthood. These patterns and reflexes are the foundation for the physical skills of learning. We got on the floor, moved about and learned manual and coaching skills to set goals and facilitate change in ourselves and in others, all aimed at enabling us to do what we want to do with greater ease. When we’re under stress, we tend to rely on our most primitive stable movement patterns, and if the developmental patterns along the way are not successfully integrated, we develop less efficient ways of performing. When our movements are integrated and we’re moving efficiently, there are so many more possibilities, physically, emotionally and mentally to do our best! ME 1 offered me the opportunity to experience this first hand and it was life changing, both personally and professionally.

With its application to the children and families we work with, we know that movement is a powerful agent for change. But “noticing” (or being aware of our own bodies) at a deeper level is equally as powerful first. During any given task, I invite you and your children to notice your breathing, muscle tension, balance and motivation for doing what you are doing. Notice how these things feel during both easy/fun activities and those that are more challenging. Through using playful activities that incorporate developmental movement patterns, along with Brain Gym movements, there are so many opportunities to make learning, moving, doing and being more integrated, efficient and richer experiences!

Liz’s interest and that of a few others at Pediatric Therapeutics who are either experienced in Brain Gym or eager to learn, led to an Intro to Brain Gym class hosted by Pediatric Therapeutics this past spring!

To learn more about Brain Gym, schedule a session with Liz or join us for our next Brain Gym workshop.

–Liz Duffy
–Sheila Allen
2018

2018 Summer Reading List

Collage

Last August we shared some of our summer vacation reading ideas and favorite places to savor the reading experience. Our reading list was met with interest, follow up questions and requests for more, so we heartily share an updated list of books currently entertaining many of us. Although reading is something most of our staff enjoys year round, there is something special about summer or vacation reading. Check out our latest picks below!

Piano Tide by Kathleen Dean Moore

When by Daniel Pink

Worth It by Erin Matlock

Little Fires Everywhere by Celeste Ng

Station Eleven by Emily St John Mandel

How to Talk to a Widower by Jonathan Tropper

The Woman in the Window by AJ Finn

Unaccustomed Earth by Jhumpa Lahiri

Leonardo DaVinci by Walter Isaacson

Not That I Could Tell by Jessica Strawser

An Invisible Thread by Laura Schroff

Behind the Beautiful Forevers by Katherine Boo

Calypso by David Sedaris

Chesapeake by James Michener

Want some more suggestions? Check out last year’s list, here!

–Anne Toolajian, MA, CCC-SLP

The Jumps of June

star

June is a month of jumps and the celebration of them, however high or far they take you, whether you’re the jumper or not. I’m referring to the jumps that bring us up or forward, that are eager responses to opportunity, and that enable us to clear the obstacles in our paths…jumps that begin on solid ground or with solid footing and move us by virtue of our own actions. These are the type of jumps that are voluntary, the type that bring about and have become synonymous with rising, soaring, and increasing. They’re both achievements and a means toward them. I love these kinds of jumps. I love them so much that I have a job that’s helping others be the jumpers, take their jumps, and land successfully, a job that’s focused on personal achievement.

a goal + effort + courage + skill –> achievement

Whoever you are and what you do for a living, goal-setting’s a must if you’re looking to achieve something. I sure which I was as good at consciously setting goals for myself as I am for my clients! True achievements of any size begin with a goal and derive from a combination of effort, courage and skills. There’s an art and skill to achieving, it takes awareness, creativity, practice, and, oftentimes, support along the way.

After years of supporting change in others, I, like many therapists, am very much aware of ongoing achievements that line up for a BIG one that comes along. In fact, I’m so aware of my clients’ and parents’ ongoing efforts, courageousness and skill development that when something really big comes along I’m not at all surprised, yet just about burst with delight for the kids who are recognized for their achievements and their families who are right along there with them. I’m referring to the newly awarded Eagle Scout who, when he was younger, had challenges tolerating his daily environments and doing things for himself. I’m thinking about the School Star Student who, in his earlier years lacked confidence and rarely interacted with others. And there’s that Eighth Grade Grad who just received numerous academic excellence and athletic awards when only a few years ago he hated school because of challenges with reading and writing and was upset and sad, somebody who, prior to that, had an exceptionally hard time staying still for everything (!) except building. Whoever said that good things come in three’s wasn’t kidding. This cluster is well beyond good!

With full honor of the intention, emotion and work that’s behind achievements of all sizes, I’m finding this June to be a time of jumping for joy for all the kids who landed a big one and all the others who are well on their way.

–Sheila Allen, MA, OT

Ideas for Outings – Summertime and Year-Round

Question: I’ve scheduled my nine year daughter who has special sensory, communication and motor needs for summer camp, but I am still looking for some ideas for fun outings/activities she can enjoy with her older and younger siblings for the summer. Any ideas?

Answer: YES! Here are five ideas for some sibling fun when one of those siblings has special needs-

1. Create and Grow with OT Flo
Sign your daughter and one (or more!) of her brothers/sisters up for Create and Grow with OT Flo at Pediatric Therapeutics, a program that combines OT and arts instruction, offering creative activities for kids of all abilities. It begins July 11, with two sessions, one running in July and the first week of August, and the other in August; groups meet once weekly There are still some spots open! Contact Julie Hersch, julie.hersch@pediatrictherapeutics.org, 973-635-0202 to learn more.

2. The American Museum of Natural History
Register in advance by calling 212-313-7565 or e-mailing accessibility@amnh.org, and head into NYC early for an adventure at The American Museum of Natural History, Central Park West at 79th Street, Manhattan. 212-769-5100 or amnh.org. The museum runs The Discovery Squad from 9 to 10 a.m. on select Saturday mornings (6/30, 7/14, 8/04 and 9/01), offering free 40-minute guided tours of museum highlights, as well as time to explore the Discovery Room before the museum opens to the public at 10 a.m. Families are welcome to stay after the tour and enjoy regular museum hours, too. Tours are geared toward ages 5 to 9 and 10 to 14. The museum also offers Science Sense Tours, for people who are blind or have partial sight, and Sign Language Tours, for people who are deaf or have limited hearing.

3. Chuck E. Cheese
Enjoy breakfast/lunch at one of twelve Chuck E. Cheese’s (chuckecheese.com) the first Sunday of every month, when the restaurant opens two hours early (9AM) for “Sensory Sensitive Sundays,” with reduced lighting and noise, food, games and a trained staff. The East Hanover and Union restaurants are closest for most of us.

4. Sesame Place
Visit Sesame Place (sesameplace.com) , the first theme park in the world to become a Certified Autism Center, as designated by the International Board of Credentialing and Continuing Education Standards. Located at 100 Sesame Road, Langhorne, PA
215-702-3566, Sesame Place offers guests with autism specially trained staff, ride accessiblity, quiet rooms and low sensory areas, access to noise-canceling headphones, and assistance in making dining and watching the parade more suitable for ASD needs. Julia, the character with autism on “Sesame Street” will also be at the park greeting children.

5. AMC Movie Theatre – Mountainside
Check the movie schedule at the AMC movie theatre in Mountainside (amctheatres.com) and go to a movie. On the second and fourth Saturdays of the month films that are sensory friendly and for all ages are shown.

Looking for more? Check https://www.app.com/story/entertainment/events/2018/04/03/places-autism-friendly-entertainment/479072002/. Many of the ideas on this site will be fun for all.

–Sheila Allen, MA, OT

Get Set for Kindergarten

Screen Shot 2018-05-16 at 4.03.54 PM

If your child’s heading to kindergarten in the fall, chances are that preschool graduation is highlighted on your calendar. An exciting time and a milestone transition! If you’re looking to support that transition and/or your child’s pre-K skills, you’ll be happy to know that once again this summer, OTs Liz Duffy and Missy Briody are planning to offer “Get Set for Kindergarten”, a group aimed at developing, reinforcing or maintaining skills and behaviors conducive to learning & being a member of a kindergarten classroom community. “Get Set for Kindergarten” will begin July 11th and run 6 weeks, meeting weekly on Wednesdays from 3-4:30. Contact Liz Duffy at 973-635-0202 or elizabeth.duffy@pediatrictherapeutics.org to learn more.

Communication For All

Untitled-5

Each May provides an opportunity to raise awareness about the role of Speech-Language Pathologists and Audiologists. The theme for this year’s Better Hearing and Speech Month is Communication for All. According to ASHA (the American Speech-Language-Hearing Association), 11% of children ages 3 to 6 years have a speech, language, voice or swallowing disorder and almost 15% of school age children experience some degree of hearing loss. The SLPs at Pediatric Therapeutics feel strongly that early detection and early intervention are some of our best tools in treating childhood communication concerns.

• By first grade, most children can understand close to 10,000 words. (asha.org)
• One in every ten Americans has some form of hearing loss. (asha.org)
• The stapes, the stirrup-shaped bone in the middle ear, is the smallest bone in the human body. (wikipedia)
• Early literacy skills such as vocabulary knowledge, narrative skills, phonological awareness and letter recognition predict reading and writing success in young children. (asha.org)
• Feeding disorders typically develop for several reasons including specific medical conditions, anatomical or structural abnormalities, and reinforcement of particular behaviors. In most cases, several factors interact to produce the feeding issue or disorder. (kennedykrieger.org)
• Multiples (ie. twins, triplets, etc.) tend to experience a higher rate of speech and language development disorders. Many factors including personality differences, gender, and increased demands on family members contribute to a speech and/or language delay in multiples. Multiples often engage in twin talk, a spoken language or a language of gestures and body language. Multiples are often so effective at communicating with each other that their speech and language development can be delayed. (verywellfamily.com)

— Anne Toolajian, MA, CCC-SLP

Sensory Processing and Autism: A Piece of the Puzzle

Untitled-2

Question: I’ve read that Autism Spectrum Disorder and Sensory Processing Disorder are two distinct conditions. With that said, why do my child’s therapists and teachers keep talking about his sensory processing problems when he is diagnosed as having Autism?

Answer: With at least three quarters of children with Autism Spectrum Disorder (ASD) showing signs of Sensory Processing Disorder, (SPD) your child is not alone! Interestingly, the reverse is not so – most children with SPD do not have ASD, according to research conducted or compiled by the STAR Institute (SPDStar.org).

While diagnosis is important, one of the essential matters here is the processing of sensation, the basis for our understanding of ourselves and our world, and for our everyday interactions with the people, objects and surroundings of our lives. The bottom line – while there are many factors that could contribute to behavior that is well suited to life’s occurrences, the more accurately and efficiently we’re able to pick up on, and understand sensory information relevant to our daily lives, the better equipped we are to respond. Unreliable and/or insufficient sensory processing is often a foundation of inappropriate or less-than-desirable behavior. It can contribute to limited tolerance for everyday situations, outbursts & tantrums, repetitive actions, inflexibility or rigidity related to environmental characteristics, an inability to fit in or “sync up” with others and/or the pace of daily events, difficulty figuring out how to do things, difficulty acquiring and applying skills, and so much more. Disordered sensory processing also can affect sleep/rest, nutritious eating and movement, the mainstays of our wellbeing.

Since both Autism and Sensory Processing Disorder both involve differences in patterns of responsiveness to sensation, when it comes to planning how we can help with change it seems easiest and most logical to think sensory. Over responsiveness to sensory input, such as certain sounds and touch, as well as light, movement (including dynamically moving surroundings such as a crowded place or a playground) is very common. People with over responsiveness are extra sensitive to, cannot filter, and are often uncomfortable with or frightened by stimulation that neurotypical people may not even notice. Their heightened sensitivity is apt to interfere with their ability to engage and discriminate because they move into a state of heightened arousal often associated with “fight, flight, fright or freeze”. On the other hand, those who are under responsive generally need a good deal of stimulation, beyond what is provided in so-called typical daily life, in order to be alert, discriminative and active. Under responsiveness is also prevalent. Often people who are under responsive seek the sensation they need; craving and seeking of movement, deep pressure, and sensations gained through intense physical effort are most common. Many people with sensory processing differences present both under responsiveness and over responsiveness; day-to-day variability is also frequently noted. While standardized testing (such as the Sensory Integration and Praxis Tests administered by certified professionals) is helpful in diagnosing and understanding sensory issues, observation and careful consideration of a child’s behavior in home, school/daycare and community settings by an OT trained in sensory integration assessment and methodology often proves to be most useful, particularly in cases of more severe sensitivity, behavioral challenges and inattentiveness or age. Assessing and treating disordered sensory processing involves both the individual and the environment.

The good news – decades worth of neuroplasticity research supports the basic premise of treatment of sensory problems – experience can bring about change, or, in other words what we sense and how we respond to it is transformational! Opportunities for participation and adaptation, created with priority given to the nature of the stimulation provided and individuals’ characteristic patterns of responsiveness, can nourish change in central nervous system structure and/or function, and change in our abilities through our lifespan. While those of us experienced in serving people with sensory differences know this because we see it, most people within the general public have come to realize for themselves that, somehow, what we experience shapes who we are and how we function. The other news – there’s still an inconceivable amount of information to be learned about sensory processing. Your child’s therapists and teachers know and respect this! Likely they are continuously bringing up his/her sensory processing because they believe it is at the foundation of his/her performance, from his/her ability to control himself in varied situations, to his/her ability to successfully interact interpersonally and form relationships and his/her ability to experience the success and fun that helps bring about brain and functional change.

To finish up, here are a few suggestions to get started thinking and working “sensory” with your child’s therapists and teachers:
• If you haven’t done so already, ask your OT about both you and your child’s teachers completing either the Sensory Profile or the Sensory Processing Measure (both are checklists), and arranging a meeting to discuss patterns and/or dissimilarities that emerge. Both provide nice structure to help frame, interpret and understand observations.
• Consider both sensory-based assets & liabilities, and recognize both preferences & aversions.
• Get to know more about your therapists’ and teachers’ frames-of-reference and approaches to sensory processing.
• With your OT or team, make a list of specific desired home and school behaviors, discuss sensory contributions to those behaviors (or current less-than-desirable behaviors)/functional skills, and develop a few sensory strategies that can be implemented consistently at home and school. Make sure to consider what is done proactively and what is done in response to your child’s actions, as well as how desired behaviors will be acknowledged.
• Stimulation your child loves is so important! Be mindful of how/when it’s provided, and make sure you get involved and share his/her joy!

-Sheila Allen, MA OT

Moving in Time: Beat & Rhythm in the Sensory Gym

Moving_in_Time_Workshop_Flyer1

Moving_in_Time_Workshop_Flyer2

Create & Grow with “OT Flo”

OT Flo (1)