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Sensational Development Occupational Therapy of Massapequa, NY provides skilled, child-centered individual and group intervention for children ages birth through 21 who may be experiencing difficulty with daily activities such as self-care, academics, play, social skills, organization, coordination, and behavior. We have teamed up with some of the most dynamic and passionate instructors and we are thrilled to now be offering Yoga! Please call for scheduling and reservations.

Blog

Blog posts by the staff at sensational development. We post information and topics of interest for our clients.

 

   You’re on a diet? NO, I’m on a “Sensory Diet”

Sara Rutledge

When hearing the word “diet”, as a society, we immediately associate the word with eating healthier or limiting our intake of certain foods and beverages. For parents, when the term “sensory diet” is first introduced, a variety of questions of confusion and curiosity may come into play. Have no fear- this type of diet has no effect on what your child can/cannot eat but what in fact your child can do throughout his/her day to help and assist with attention, arousal, and adaptive responses. A sensory diet is a carefully planned program of specific sensory-based activities that are scheduled according to each child’s needs, consisting of specific components and “nutrition” for the central nervous system (CNS).

Children with a Sensory Processing Disorder (SPD) may have a difficult time adjusting to everyday stimuli that may not appear as a problem to a person without sensory-processing difficulties. As a child who may have a difficult time adjusting everyday stimuli it may illustrate an under-responsive behavior (low arousal) or an over-responsive behavior (high arousal) (Wilbarger & Wilbarger, 2002). With these children who have a hard time adjusting or modulating his/her behaviors, this may effect a child’s participation in everyday childhood “occupations”, or behaviors and roles that are important to the child’s growth and development. Examples of “occupations” that are important throughout childhood are play, self-care, school, and sleep.  

With all of this information the next step is asking; how is a sensory diet created? As an occupational therapist it is our role to help assist in creating the sensory diet, with the help of parents/guardians, teachers etc. that are with the child on a daily basis. The key to creating a successful sensory diet is by gathering information on the child's day, routines and schedules in addition to observations of the child and how they respond to sensory experiences.  In terms of writing down your child’s daily activities, it is important to note/comment on your child’s performance or activity level during these times or activities. The more detailed you are the more helpful your information will be in determining sensory diet activities and/or tasks that will benefit your child in his/her environment.

For parents and children with a Sensory Processing Disorder, incorporating a sensory diet into his/her daily routine may be helpful in allowing the child to perform as optimally as possible in his/her environment. With this being said, there may be trial and error process, and this is not something to get discouraged about. With the help of your child’s occupational therapist, teachers, and supporters, your child will find a variation of different activities/tasks to helpful maintain an optimal arousal level, in order to find success in each activity throughout the day. Every child with Sensory Processing Disorder is unique and this will reflect each sensory diet differently. Some activities may work for your child and some may not; it is important to stay positive and work through this process- it will be worth the wait!

 

- Marisa DiRienzo, OTS

 

What is postural control? Why is it important?

Sara Rutledge

                        What is postural control? Why is it important?

 

Whether you are eating at the dinner table or sitting down in the car, your posture is used as a support to help maintain an upright position and alignment while you engage in these tasks, against gravity. Postural control can be defined as, “the act of maintaining, achieving, or restoring a state of balance during any posture or activity”(Nichols, 1996).  Although postural control is a developmental process, this does not mean that it develops normally in everyone. Development of posture is important in terms of having the appropriate muscles to keep ourselves in a appropriate position, but this is not the case in everyone.  

Some signs of poor postural control include:

·         Sitting on a chair in slouched position.

·         Leaning far onto table top to gain support while sitting.

·         Frequent falls while seated.

·         Difficulty on playground equipment such as slides, poles, see saws, and swings.

  • Walking with wide base of support and sitting in W-sit wide position.

According to Margaret Rood, and her theory, an important aspect of postural control is the development of antigravity movements. She proposed a four-stage sequence in the development of movement: 1) mobility, 2) stability, 3) mobility superimposed on stability, and 4) skill.  This theory describes the way our stability and proximal mobility should be developed first for the maintenance of weight bearing postures and shifting positions. Once our body is stable, and muscles are strong enough for weight bearing is when more distal movement (hands, feet etc.) are used to perform skillful tasks.

Postural development is associated with maturational and experimental changes in the sensorimotor, musculoskeletal, and cognitive systems; any of these systems can result in atypical postural development. An example of a task that postural control is important for is toileting. Before children sit independently on the toilet, they need to feel posturally secure. Another task that postural control and proximal stability is important for is handwriting. Often, children with poor handwriting frequently exhibit poor proximal stability.

Activities to encourage cocontraction through the neck, shoulders, elbows, and wrists in young children include:

o    animal walks such as crab walks, bear walks, snake crawl etc.

o    wheelbarrow walks

o    Playing games or doing written work while lying on tummy.

Older children may enjoy exercises such as exercises, using resistive object such as:

o    therabands

o    yoga poses requiring weight bearing on the upper extremities.

o    Tug-of-war

Helpful hints:

·         Change your child’s body position during activities e.g. kneeling to do an activity, propping on their arms/elbows when lying on their stomach.

·         When sitting down to do activities, ensure any tables and chairs are at the correct height. Their feet should be flat on the floor and their knees and hips at a 90º angle. Their back should also be straight and their shoulders relaxed when their forearms are resting on the tabletop.

 

-Marisa DiRienzo, OTS

Happy Halloween

Sara Rutledge

Fall is a time of the year that many people seem to look forward to and enjoy. This season is filled with the anticipation of changing leaves, apple and pumpkin picking, and of course all of the events surrounding and leading up to Halloween.  Although the traditional preparation and activities involved with Halloween may be a fun and exciting for most families, a reasonable number of children may also find this time to be filled with frightening decorations, uncomfortable costumes, and unpredictable sounds and surprises.  The anticipation of encountering these holiday stressors may cause a child to experience anxiety and discomfort in the presence of Halloween events.  As individuals who celebrate Halloween by distributing candy, Trick-or-Treating, and attending costume parties, it is important to remain aware of these stressors, do our best to prepare our children for this event, modify the environment to address their concerns, and provide every child with the opportunity to participate in this exciting holiday. 

In the last few years, there has been a powerful quote shared throughout social media that has raised awareness of the challenges that many children may face during the events that surround this fright-filled holiday.  It reminds us to remain open minded about each individual child’s needs and be aware of our ability to remain patient and try to understand that the children we see celebrating this day may be facing their own obstacles in order to engage in the various Halloween activities. 

The Teal Pumpkin Project is a program that facilitates a safer, healthier and happier Halloween for the large amount of children who have allergies and are unable to participate in the traditional trick-or-treating experience.  The teal pumpkin signifies non-food related items that will be given out by the house, for example bubbles, necklaces, jacks, and puzzles to name a few.  By placing a teal painted pumpkin in front of your house, these children will be able to have a great experience with their friends.   

Tonight a lot of creatures will visit your door. Be open- minded. The child who is grabbing more than one piece of candy might have poor fine motor skills. The child who takes forever to pick out one piece of candy might have motor planning issues. The child who does not say “trick or treat” or “thank you” might be painfully shy, non-verbal, or selectively mute. If you cannot understand their words, they may struggle with developmental speech.  The child who looks disappointed when he sees your bowl might have an allergy. The child who isn’t wearing a costume at all might have SPD or autism. Be kind, be patient, smile, pretend you understand. It’s everyone’s Halloween.

When reading the above quote, it may seem easy to remain patient and understanding throughout the day of Halloween. However, there are additional steps we can take to help prepare children for the excitement of the day and provide them with an environment that will promotetheir ability to participate in the holiday activities while remaining aware of their needs and concerns. Here are some tips and strategies to ease the stress of Halloween and assist in creating a fun and interactive day. Do you have any additional tips that have been helpful for your family on Halloween? Please share in the comments below!

Prepare your child for the holidaytraditions:

Discuss some of the traditions and activities that surround Halloween. Read a book, create a social story, or role-play some of the events they may experience.  Establish and review the rules and boundaries regarding certain activities (i.e. Trick-or-Treating or approaching strangers).

Be flexible when choosing and wearing a costume:

Remember that an outfit does not need to be elaborate to be considered a costume. Be aware of the costume’s qualities including the texture, beading, stiffness, and restrictiveness. Allow your child to try out various costumes and decide which is best for him. Let your child know that he may change his costume as needed, or may participate in Halloween activities without a costume if preferred. Practice wearing the costume at home to become familiar with the fit and to become accustomed to others’ reactions to the outfit.

Map out a pre-planned Trick-or-Treat route:

In the upcoming weeks, travel around your town and be aware of houses that may be too scary or areas that may become very busy during the Trick-or-Treating hours. Prepare a route to follow that avoids large crowds, loud noises, scary decorations, and heavy traffic.  If possible, go to houses or friends or family members.  Prepare your child and remind them that they can pass by houses that may have too many children at the door, people with scary costumes, or frightening decorations.

Practice the sequence of walking to the door, saying “trick-or-treat”, putting the treat in the bag, and saying thank you. Remember that even a short Trick-or-treat session can be fun!

If your child does not want to Trick-or-Treat, choose alternative activities:

Trick-or-treating is not mandatory. Meaningful participation in Halloween activities can include making Halloween crafts, carving a pumpkin, bobbing for apples, watching Halloween themed movies, or even handing out candy at home.  Choose activities that benefit your child’s needs.

Focus on your child’s sensory diet to prepare for the Halloween activities:

Complete heavy work and proprioceptive activities at home prior to engaging in exciting Halloween events. Provide your child with exercises or activities that will promote regulating his body in preparation for a busy day filled with many stimulating events.

Consider noise-canceling headphones during events that may have loud music, large crowds, or unexpected sounds from decorations.

Allow all children to participate in party games and activities:

Although some children may enjoy getting messy and carving a pumpkin, this activity may cause other children discomfort. Allow children to decorate pumpkins with markers or stickers. Show children that a dark or overwhelming room can be modified by turning on the lights, decreasing music volume, and covering decorations.

Be aware of the various “treats” that your child is given:

Many candies and foods may contain allergens and trigger food sensitivities. Establish rules on making sure an adult checks the “treats” before the child eats them. Be aware of “hidden” ingredients such as soy, milk products, and red-dye.

Monitor your child’s behaviors and reactions throughout these Halloween events:

Throughout these Halloween events, it is important to remain alert and aware of your child’s behaviors and arousal level to help them fully participate in the desired holiday activities.  Some things to consider include limiting the duration and number of people and activities, give your child notice and advanced sequence of the upcoming events, and practice using phrases such as “is it my turn?” and “please don’t touch my costume”.

Know when your child is giving you signs that it is time to disengage from an activity. Recognize the signs of sensory overload including fatigue, crying, easily frustrated, and increased level of arousal or excitement. Provide your child with a quiet and safe environment when activities become too overwhelming.

Preparing your children for Halloween and providing them with a safe and understanding environment will encourage them to participate in the various holiday festivities and enjoy a day filled with fun and exciting events for everyone!

Liana Spiciarich, MS OTR/L

Sara Rutledge, MS OTr/L

There is so much more to writing than holding a pencil!

Sara Rutledge

Foundational skills are often overlooked when talking about handwriting. Neat, legible handwriting does not come overnight. There are many prerequisites that need to be acquired before a child’s handwriting performance can improve. In order to build a solid foundation for handwriting, a developmental progression of hand functioning and hand skills must be reached.

We all need adequate core muscles for everyday activity. Children need stable cores to maintain upright postures in their seats, develop shoulder stability and adequate fine motor skills. Going hand-in-hand with core muscles is trunk control. To understand the importance of a strong and stable trunk, just think about a fishing rod. Imagine a rod made of rubber. Try casting a line - it simply wouldn't work. With a floppy rod your control of the line and hook would be non-existent. A child's trunk is like the fishing rod. A strong and steady trunk provides the base of support needed for delicate fine motor tasks like writing (Handwriting Help for Kids, 2001).

Did you ever think that postural stability could have an impact on your handwriting? It is critical to have proximal stability in order for the more distal muscle groups to perform fine movements. Many muscles around the shoulder work together to hold this joint stable when performing fine motor tasks. If a child has poor shoulder stability, then he/she cannot hold this joint stable, impacting fine motor control. If this joint is loose, then fine motor control needed for writing is impossible to achieve. A strong upper body and shoulders are necessary for controlled movements of the hand and fingers. Without a stable base of support it is difficult to guide the eyes and hands to work together.

            Each hand is divided into two separate sides: the precision side and the power side. The radial (thumb) side of one’s hand is important for precision with manual dexterity such as threading a needle or buttoning a shirt.  The ulnar (little finger) side of the hand is important for power such as opening a jar.  Together these two features of the hand comprise the necessary prerequisites for fine motor control.  Writing, coloring, and scissoring require stability of the ulnar side of the hand while the small muscles of the radial side of the hand produce small precise strokes/snips for proper motor control.

            As a child’s strength and control develops, the movement of writing will move from the whole arm, to the wrist, and finally to the fingertips. Intrinsic muscle movement can be seen when the ulnar side of the hand is stabilized on the table while the fingers move a pencil to write. The intrinsic movements are best observed in activities that require the tips of the thumb, index finger, and middle finger be touching while they are performing flexion with the thumb is in extension.

Motor planning involves spontaneously sequencing and organizing movements in a coordinated manner to complete unfamiliar motor tasks. Timing and sequencing are essential to motor planning, as well as ideation (how to approach a novel task) and execution (how to follow through with a novel task).  Adequate motor planning abilities are needed for writing; some examples are: knowing how to form letters and where to start the letter, spatially planning a sentence and knowing when to move to the next line, coming up with an idea for a story or sentence, and knowing the relationship or part to whole.

There are so many different pieces and components to handwriting that go unrecognized. Every piece to this ‘puzzle’ is equally as important as the next and has its own impact on the puzzle as a whole. Until all the pieces comes together, functional and successful handwriting is much more difficult to achieve!

Rachel Durante, MS OTR/L