Get Set for Kindergarten

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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

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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

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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

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Create & Grow with “OT Flo”

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How can I help my child navigate the world of competition with greater understanding and more fun?

Q: How can I help my child navigate the world of competition with greater understanding and more fun?

A: With the 2018 Winter Olympic Games coming to an end and the 2018 Paralympics set to begin in PyeongChang from March 8-18, it is an excellent time to discuss how competition and “games” affect us all. The 2018 Special Olympics will be in Seattle from July 1-6 this summer and will provide another rich opportunity for continued conversation. It is certainly not just about sports and athleticism but how we each perceive the interaction between ourselves and our teammates, classmates, friends and family members.

For those who have watched, the past two and a half weeks of Olympic coverage have provided moments of suspense, rattled nerves, sheer determination, loss, immense gratitude, relief and joy. We have witnessed inspiring glimpses of positive sportsmanship, team work and even photo finishes! There have been opportunities to cheer one another’s successes as well as comfort those in despair.

What has been YOUR favorite scene or sensation from these Winter Games? What have your children enjoyed? Questioned? Favored? What lessons can we each take away from this shared global experience? How one chooses to react to these myriad examples can and will inform how our children view themselves. Competition obviously doesn’t just take place on the half pipe or skating rink or bobsled track. It is present in every facet of our lives. Ongoing research continues to remind us of the effects of anxiety and stress on ourselves and our developing children. Every skater falls, every commentator fumbles and every participant has challenges. How each one responds to the ups and downs is the place where learning occurs!!

One way to continue the FUN of the Games while furthering the conversation about resiliency and participation can be found in working together on some simple but stimulating crafts which illuminate the spirit of collaboration without the angst or nerves of competition.

Use this printable worksheet to make flags of the world or flags of your own choosing. What a fun and informative way to discuss similarities and differences between cultures.

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• Trace the rings and give examples of each of the qualities listed and how they overlap and intersect each other. How can this apply to activities on the playground or in the lunchroom or during recess? (c/o Pinterest)

OLYMPIC RINGS

• Enjoy easy, delicious, healthy, and FUN snacks—Olympic-style! Cut and toast bagels and decorate with cream cheese and colorful fruit pieces. (c/o Cool Mom Picks)

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Try this super easy and quick way to make a ring toss game using just some cardboard and empty toilet paper holders along with markers or paint and some glue. Play for prizes or just play for FUN!

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May all your adventures, whether Olympic in size or not, be inclusive, be rewarding and be FUN!

–Anne Toolajian, MA, CCC-SLP

Juicy in 2018!

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Image from https://juicing-for-health.com/

Did you know that freshly extracted fruit and vegetable juices “flood your body with a river of goodness”, providing your body with a dense concentration of the nutrients it needs? Have you ever tried to get your kids to eat (or eat enough) of vegetables you know are good for them? If you’re interested in nutrition, and believe in the importance of eating vegetables and fruit, you must check out juicing-for-health.com. Here you’ll find basically all you need to get yourself started with making fresh juices, and a good deal of interesting information and recipes if you’re already an established juicer. Combine what juicing-for-health.com has to offer with advice, ideas and more recipes from all-about-juicing.com, and even more Jessica Fisher’s Best 100 Juices for Kids (Harvard Common Press, 2014), and you’ll be set! Even better, you’ll also be ready to have your kids help you and you’ll all experience a sensory and language-rich fine motor/sequential processing activity.

Two recipes to get you started:

a basic, simple, loved-by-kids juice,
Apple Berry Juice (15-20 ounces)
1 1/2 c. berries, mixed if preferred (strawberries, blueberries, raspberries)
2 medium apples
Use whatever berries you have on hand.
Add extra apples if you’re short on berries.
Remove hulls, if using strawberries.
Core apples (I like to remove skin, too).
Juice berries and apples according to juicing machine directions.
Whisk to combine.
Add water to taste if a milder juice is preferred.
(from Best 100 Juices for Kids)

a green juice believed to help with calming nerves, relaxing the body and falling asleep,
Green Sleep Juice (1 serving)
½ a bunch of watercress
8 ribs of celery
4-5 heads of Romaine lettuce (or a bunch of spinach)
2 green apples
1 lemon (peeled)
Put all of the above through your juicer.
(from juicing-for-health)

–Sheila Allen, MA, OT

There’s Something About the Beginning of a New Year

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Resolutions? You bet. Within our Pediatric Therapeutics community, our therapists and staff are, for the most part, resolution setters who made commitments to themselves at the beginning of 2017 that, a year later, have been integrated into the rhythms of their lives. How about that?! Moving into 2018, most of us have moved on to other resolutions, while some of us see ourselves as more involved in an ongoing process of goal setting. The New Year as a source of inspiration? We all consider it as such! More of us are inspired by the new year than by our own birthdays or those of others (except the birthdays of our own children or family elders, which were highly inspiring ). More of us are inspired by the New Year than by the beginnings of new days. Even those of us who feel the inspiration brought by a new day feel the uniqueness of January 1.

The end of a year and beginning of a new one come to mind as a singular event that’s not only acknowledged but celebrated throughout the world and marked by most people. When else does the world community join together as it does when ushering in a new year, and when else do so many people think and speak about personal change? Humankind continues a profound practice of honoring time, its steady beat of passage and the multitude of rhythms within it. At the beginning of a year the power of this practice seems to be at its all time highest, likely contributing to the infectious cycle of renewal, refreshment and resolve that January 1 spurs in a way unlike any other day of the calendar year.

Most Pediatric Therapeutics therapists and staff resolutions/goals center around a few common themes – simplification; slowing down to fully experience, enjoy and appreciate; positivity; and physiologic foundations of wellbeing (aka sleep, diet and movement). Some of us make ourselves accountable with very specific commitments and plans, while others among us hold our pledges as conscious thoughts. With either approach, living the process of making personal change includes granting oneself permission to start anew, no matter what, no matter when…not such an easy thing, as a few of our group wisely point out.

What if the New Year came with a wish list? Our does! Health (personal, family members, friends) topped the Pediatric Therapeutics New Year’s wish list. More family time, at home and away, was right up there too. A wish for longer lasting special moments also got a shout out. It may come as a surprise, but we’re not a group in which winning the lottery is the top wish…oh, but wouldn’t that be something!

The newness time can offer us is a gift like no other, whether it begins with January 1, a birthday, a day, January 1, or one of those special moments. A true gift that keeps giving, and ours for the taking, to be and do with it what we will! Powerful, perhaps daunting, and an undeniable source of inspiration!

–Sheila Allen, MA, OT

The Importance of Sensory Awareness

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The processing of sensory information is something we all do. Sensory processing is the means by which we receive, interpret, organize and use the stimulation that activates our eight senses – hearing, sense of position/movement (vestibular), sense of body part position/movement (proprioception & kinesthesia), feelings of what’s going on within our bodies (interoception) touch/tactile, vision, taste, and smell.

Each one of us is processing sensory information continuously, consciously and subconsciously.

When sensory processing is effective we respond to life’s sensory events (both those related to ourselves and those within our surroundings) adaptively. When sensory processing is a problem, it may be related to the function of a specific sensory organ or sensory system, or it may be related to a neurologically-based condition known as sensory processing disorder, whereby sensory function is less than reliable to varied degrees. Stimulation may be poorly adjusted to, misinterpreted, missed, tuned into with heightened sensitivity, sensed as uncomfortable or adverse, avoided, craved, or inadequately filtered. Most frequently, with a sensory processing disorder more than one sensory system is involved and there is variability among the systems involved. Those with disordered sensory processing either must work harder to respond adaptively, or they experience problems that could manifest in many different ways because the processing of sensory stimulation is at the foundation when it comes to how we function.

Awareness of sensory stimulation and individuals’ patterns of responses to basic sensory information is not only helpful, it’s essential in understanding and changing behavior and performance.

Here’re a dozen reasons why sensory awareness is important –

1. Sensory stimulation affects our physiology, psychology, emotionality, motor function, language, thinking, learning, interaction and development through our lifespan.
2. Reliable and sufficient sensory input is necessary for adaptive appropriate output.
3. Everyone tunes into sensory information his/her own ways.
4. How a person takes in sensory information naturally varies from day to day, and within the 24 hours of a day.
5. Different types of sensory information may be processed and affect behavior in different ways
6. Sensory stimulation (aka our experiences) can affect brain change when provided with at critical intensity and frequency over a span of time, for better or worse. With brain change, sensory processing can change.
7. The chicken or the egg? Dysfunctional sensory processing can lead to other problems such as inadequate sleep, attentional limitations, anxiety, emotional reactivity and motor skill deficits, and in turn, problems such as these can affect how sensory information is received.
8. Stress can interfere with sensory processing.
9. Oftentimes if someone is feeling the need to protect him/herself from a certain type of stimulation that isn’t comfortable or tolerable, discrimination of the qualities of the stimulation ultimately suffers.
10. Sensory processing affects the value of repetition. Repetition, which is a valuable tool for learning, is not true repetition if the stimulation taken in and responded to is processed differently from day to day.
11. Sensory processing can affect our awareness of and thoughts about ourselves, as well as our awareness and interaction with others and our surroundings.
12. Sensory processing dysfunction can exist without a known cause, yet it can also alongside other conditions, such as autism, ADHD, ADD, prematurity, it often subjectively appears to be genetically related, and can also be related to trauma.

Each occupational therapist at Pediatric Therapeutics is trained and experienced in the evaluation, treatment and management of sensory processing disorder. Interested in learning more about sensory processing disorder and other sensory based problems? Give us a call, or email info@pediatrictherapeutics.org and we’ll be in touch to answer your questions and direct you to resources.

–Sheila Allen, MA, OT

A Note from Griffen…

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Earlier this month Griffen’s parents were checking his work for school (explain and relate to an assigned precept) and what they found sent them “over the moon”… It did the same for us, and we can only imagine what his teachers felt when they received it.  Sometimes the teacher isn’t giving the bonus points when assignments are completed, he/she gets them…the honest, trusting sharing of an appreciative student, not to mention an endearing and engaging fulfillment of an assignment.  Thanks to Griffen and his parents for allowing us to share this inspiring, heartfelt, unedited message he simply referred to as “homework”. 

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“This precept means to me that you should never doubt yourself, like when you feel you can’t do something, but you actually can do it. I think you chose this precept because it can mean a lot to a child in a way that it feels like you feel it inside you. This precept can relate to my life because, honestly, I normally doubt myself in ways, like thinking I can’t do sports, but I can. It feels like a very honest thing to me, and I realize that I CAN BE GOOD ENOUGH and never give up.

I hope you understand everything I’ve told to you thus far, and I will try everything I can. I feel happier now that I told that to you, just got it off my chest. I feel…actually cheerful for once.

I love being your student, Mr. ____. Thank you SO much for doing teaching so well in ways even a kindergartner would understand (in a nice way, because your teaching are easy to understand and happy to work with), and I hope you continue this even when I’m in middle school. High school. COLLEGE. Thank you. Innovation is abound when you and Mrs. ___ teaches, and also Ms. _____ as well.

: D : D : D : D..wait, I’m going off topic, aren’t I?.. Sorry, I just answered all the questions and I’m not sure how to continue at this point, OK?

Thanks for teaching me so far. I feel happy. Sorry for doing this later than expected. When I wanted to do it on Thursday, my internet went down due to cleaners getting the Wi-Fi router wet. Had to wait until yesterday to get on the Internet. It was excruciating. At least my family went to Arturo’s (the pizza shop, Griffen recommends) the night before I got back on.

I hope you like this!

You’re a very nice teacher! (out of things to say at this point) (ONE MORE THING) It’s awesome that you teach. Is this too many lines for one answer now? Not sure.

I hope you’re having a nice day. Sorry about the situation you’re in, and that you can’t get much done. I hope you never give up, despite the situation.”

–Griffen, Age 10