GO Out of Your Comfort Zone

Self-LoveAs many of my readers know, I’m the mother to two children with autism spectrum disorders and to complicate things even more, my younger son has a terrible rare disease which renders him un-able to eat food by mouth. He must be strictly fed by a tube in his stomach to live. I can presume that no little girl dreams of this life I’m living when thinking about her future-I surely did NOT. Yet, I am extremely thankful for my children and the life I’ve been blessed with.

At one of my son’s countless numbers of psychology appointments yesterday, I was struck by something the doctor said. “We cannot grow or experience the beauty of things unless we travel out of our comfort zone.” I was immediately speechless (which does not happen often ;)). He was encouraging my son to work on eating fruits and veggies for a more healthy diet but I got MUCH MORE from his statement.

How many times in your life have you dreaded going to this or that event out of the fear of the unknown? Usually what happens is you attend the event and have a wonderful time and are thankful you went to experience something new. In fact, to learn and grow we must all move a bit out of our comfort zone. Think of a baby as he learns to sit up. He has not tried it before and he most likely will fall, yet he knows no fear and tries anyway. Our bodies are hard-wired to try new experiences from the time we are born. This is how we grow and develop new skills that we will build upon for a lifetime. Reflexes gradually disappear and we innately learn to rely on those skills we have acquired. With each success comes confidence to try again, and then we become skilled.

In my book, The Pocket Occupational Therapist, I provide many ways to help children to learn skills needed for daily living. Children with special needs may need a little more encouragement to learn new skills. We need to adapt the activity for them to achieve small successes so that they may build up the confidence to try again and again. It is through this process that skills are learned. When we fail (or our child fails) it is natural for us not to want to repeat the experience. Therefore, it is our job as parents and therapists to help to facilitate successes. However, we cannot truly understand what this means until we take a good look at our own willingness to try new things. Self-evaluation is important to grow and learn. It has been said by Socrates that “the un-examined life is not worth living.” This is quite drastic, yet rings true for us. We should constantly be examining ourselves and our ability to learn from our own experiences and from our children to grow as parents, therapists, teachers.

When we understand that we do not like to fail and sometimes need a little more encouragement to achieve our goals-big or small-we are more likely to succeed. Let’s take a look at ourselves as teachers and step out of our comfort zone. Go for it!
By- Cara Koscinki MOT, OTR/L

Author of The Pocket Occupational Therapist- a handbook for caregivers of children with special needs. Questions and answers most frequently asked to OTs with easy to understand answers and fun activities you can do with your child. Order anywhere books are sold. www.pocketot.com

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Developing Skills Through PLAY

Playground FUN

Playground FUN

Occupational therapists are fortunate enough to be a critical part of the treatment team for children with special needs. Any difficulties children may face as a result of having a developmental delay should be addressed by incorporating play into their daily routine. While working with the adult population, occupational therapists focus on remediating skills for daily living and for work related tasks. When assessing the skills of children, the therapist must look at the child’s play skills. After all, when children are not asleep they are learning about their environment through the various play activities they engage in during their day. Even completing the tasks of building blocks, completing a puzzle, and drawing pictures will yield skills that the child will use throughout his lifetime.

The skills, developmental stages, and all activities listed in this blog post can be found in our book The Pocket Occupational Therapist for caregivers of families with special needs. It’s PACKED with easy to read ideas and is like having your OT with you all of the time! Can be purchased on Amazon or anywhere books are sold.

When caregivers attend occupational therapy sessions, most inevitably ask, “Why does it look like you are playing during the session? How is this therapy?” The occupational therapist should explain therapy goals and how she will work to achieve them during the course of therapy. It is important for caregivers to feel comfortable asking questions about activities to complete at home to help to facilitate therapy progress. Most caregivers want to help their child to achieve his goals and are willing to participate if given the chance. It is by asking questions and through home programs given by the therapist that caregivers can be key partners in a child’s success on building skills that will propel him through his lifetime.

The most important thing to remember when working with your child at home is to begin at a level where he can be successful. Each success will help to build his confidence. No one wants to fail at a task and oftentimes, a child with special needs may lack the confidence to re-try something at which he has previously failed. Be sure to watch your child as he plays to determine which activities he prefers. For example, note if he prefers to engage in messy play or dry play. Does he enjoy colors, shapes, letters, or numbers? When seeking items for your home play time, be sure to remember his favorite color or movie character. His excitement will help him to have fun while learning.

Fine-motor coordination involves tasks of the hands and fingers such as holding a writing utensil, using a fork, buttoning, and shoe-tying. It is a good idea to help your child to strengthen his fingers for these tasks. Set up activities that you know he will enjoy and have success with. here are many different types of dough recipes that can be found on the internet. Make some dough and add his favorite color to it with a small amount of food coloring or add glitter. Mix two different colors of dough together and see what colors you can make. The addition of different scented oils can heighten the activity to a new sensory level. Peppermint and vanilla oils are commonly found at the grocery store. Note which scents your child prefers.

Most children love to open and close things. Be sure to save containers of all shapes and sizes. After cleaning them out, place a special prize inside. Ask your child to open each and find the prize. Prizes can be food, pom-poms, treats, or anything that will be motivating for him. Cut a slit in the top of the lid and ask him to put coins or bingo chips inside the container. This will give him the opportunity to develop good coordination skills. Also, use different eye-droppers or a turkey baster to transfer colored water from cup to cup. Switch from hand to hand or have a race to see who can fill the cup up first.

Gross-motor coordination and building up a strong core muscle system will be key factors in determining success with future activities such as bicycle riding, hopping, and playing sports in the future. Even when children are infants, supervised tummy time is important to help muscles work against gravity. Place a motivating object near baby so that he has to lift his head to see it. Use lots of praise and encouragement. To help develop core muscle strength as children get older, it is important to revisit tummy time. Ask your child to watch a small portion of his favorite television show while lying on his belly. As he gets stronger build up the time. Pretending to be animals like snakes crawling in the grasslands is a fun game for older kids.

Crawling is a stage often missed by children with developmental delays. The act of crawling helps to strengthens muscles, works to help to integrate the sensory system, and develops coordination of the arms and legs. Often, we need to give extra help to learn to navigate their bodies in the quadruped, or crawling, position. We can get down on the floor with our children and crawl together through mazes made of cushions; under tables; and along paths taped with masking tape. Make sure to encourage fun so that your child doesn’t realize he’s working on skills that may be difficult for him. Allow him to rest when he needs to.

Oral-motor skills are critical to eating, drinking, and speech. Often times the local thrift store is full of affordable tools for building strength in the muscles of the mouth. Straws of different shapes and diameters should be used for drinking or blowing bubbles into a pan of water. Have races by blowing cotton balls and other light items off of the table. The use of age-appropriate whistles is a fun way to get immediate reward as the child learns to produce sounds by blowing. Place whipped crème onto the child’s lips and ask him to look into a mirror and use his tongue to lick it all off. This will help him to strengthen the tongue muscles and become more aware of its movements. Try it with him and have a race. Use different tastes and textures such as chocolate syrup.

As you think about your child, keep in mind that he is a child first and he learns critical skills through playing. It will benefit him many fold if you provide him with opportunities to work on his areas of weaknesses while he has fun doing so. Don’t be afraid, your child is happy spending time with you!

By- Cara Koscinki MOT, OTR/L

Author of The Pocket Occupational Therapist- a handbook for caregivers of children with special needs. Questions and answers most frequently asked to OTs with easy to understand answers and fun activities you can do with your child. Order anywhere books are sold. www.pocketot.com

Summer FUN (shhh…..don’t tell them it’s actually therapy)

SUMMER!
It’s here! Most families look forward to summer’s relaxation and lazy days. However, the lack of routine and structure can be the cause of great stress for families of children with special needs.
School routines are predictable and provide consistency and the transition to summer may be a difficult one. In addition, the skills your child has gained in school should be carried over into the summer to stop any regression. No ideas? Feeling overwhelmed?

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NEVER FEAR……THE POCKET OCCUPATIONAL THERAPIST is here!!

Try to keep a routine. Look at the calendar together and make a routine for your family. Include your child in choosing activities and even colors that you’ll write on the calendar with. Post a list of daily schedules and chores with check off boxes. Schedule new activities well ahead of time and be sure to prepare for them. Visit summer camp sites prior to camp, meet counselors before camp begins, and take pictures of camp locations. Make a memory booklet and encourage your child to write in a journal about his summer activities. If he’s not writing yet, ask him to draw pictures. This will be a great keepsake!

Schedule as many play dates as possible. Extended family and cousins may also be off of school and need to keep busy too. Play games together such as making up your own circus. Walk a taped line imitating a tightrope, learn to juggle, and pretend to walk like different animals in the circus. You can also pretend to make a zoo, jungle, or go on safari. Walking on all forus to imitate a bear, lion, tiger, dog, or any other animal is great for proprioceptive (heavy work) input.

Make a parade with homemade instruments. Visit our Pinterest board for ideas on how to make your own instruments out of paper plates, oat containers, and paper towel rolls. Marching to different rhythms is a fun way to work on proprioceptive input and body coordination.

Play charades and act out different sports or occupations. This is a great activity to do as a family or during a play date. For an added challenge, act out different feelings.

Draw letters and numbers using only your fingers on your child’s back. Ask him to guess what you are drawing. Let him practice on your back too.

Tape a line on the floor and ask him to jump in different ways over it. For example, hop with your right foot on the left side of the line. Jump three times on the right sice of the line. Use the line as a pretend balance beam.

Cross crawling is a great activity to help in right/left coordination and visual motor skills. Crawl by moving one arm and the opposite leg (right arm/left leg) and then switch (left arm/right leg). Try giving your child directional commands such as: “Touch your left ear with your right hand.” Be creative and encourage your child to give you directions as well. Sometimes, playing the teacher is empowering!

Evening activities at dusk are fun too. Go on a flashlight scavenger hunt with your child. Use a flashlight to draw different letters and numbers on the ground. Use glow sticks to write letters in the air. Add glow stick liquid to bubbles and have a bubble blowing competition.

Use sidewalk chalk on the concrete or on your trampoline. Ask your child to jump to the letter you call out.

Walk like a wheelbarrow in the grass. Hold your child’s ankles, knees, or thighs and ask him to “walk” on his hands. You can place different things such as bean bags or play tools onto his back to “transport” items like a real wheelbarrow does. This is an EXCELLENT activitiy to add into any sensory diet. It is filled with proprioceptive input/heavy work.

Hop scotch, jumping rope, and learning to ride a bicycle are always super summer activities.

Use a spray bottle to spray plants. Squirting each other on a hot day is a fun way to cool down while building hand strength!

Fine motor tasks such as bead stringing, macrame, puzzles, hunting for treasure in different sensory bins, card games, marbles, making letters in sand and shaving creme, jacks are all great ways to build fine motor skills.

Painting with different items such as leaves, sticks, or cotton balls is fun. Adding tweezers to any task builds fine motor coordination. Instead of picking up cotton balls with his fingers, use tweezers!

If your child has difficulty catching a hard ball such as a baseball, use a wiffleball which will move slower and is easier to catch. Playing mini-golf with plastic golf balls is a fun way to build skills without the danger of a real golf ball flying through the yard.

Make a book. Cut old magazines and paste pictures on to a book made of construction paper and bound with yarn. Write stories about the pictures or make your own. Even punching the holes (through which to bind the book) with the hole puncher is a great fine motor activity.

Make a game of feel and guess. Use an old shoebox and cut a hole for your child’s hand to fit into. Place an item such as a leaf into the box and ask your child to tell you what the item is just by the way it feels. This can be done every season and with many objects such as stones, ice cubes, and seeds.

Make puppets out of old socks and felt. Put on a puppet show for friends or family.

Give your child a treasure hunt list with items such as a butterfly, cloud shaped like a certain animal, or sound of a certain bird’s chirp. This should be a multi-sensory treasure hunt involving eyes, ears, touch, and smell.

Plan snacks that relate to different books. Examples include: Blue Berries for Sal, Stone Soup, and Bread and Jam for Frances.

Set up a store selling different summer items such as beach toys, summer fruits, and vegetables. Encourage your child to make signs for each item and practice making change when something is purchased.

Use old sheets and blankets to make tents. Go camping in your living room!

Finally, plant seeds and watch them grow. Move them from small pots or paper cups into a garden area. Chart their growth in a notebook. Encourage your child to help you with the responsibilities of watering her garden and re-potting when necessary. Caring for something such as a plant can empower a child.

Make sure to read a great book together (Don’t forget about reading and recommending The Pocket Occupational Therapist for families of children with special needs).

Most of all, HAVE FUN together! You never know when you are making a memory that your child will have for the rest of his life!

By- Cara Koscinki MOT, OTR/L

Author of The Pocket Occupational Therapist- a handbook for caregivers of children with special needs. Questions and answers most frequently asked to OTs with easy to understand answers and fun activities you can do with your child. Order anywhere books are sold. www.pocketot.com

He has a disability so he will never….

I’m re-posting one of our most popular blog posts.  Enjoy!

Recently, one of my children was diagnosed with Tourette Syndrome.  I couldn’t help but get the flash in my head that some of you may have right now….a kid screaming nasty words and slurs in public.  The media has indeed sensationalized this small portion of Tourettes.  In fact, according to the Tourette Syndrome Association, only 15% of people with TS exhibit this symptom.  With that being said, the judgement of my son immediately began.  Someone in my family said, “Great, well this means he will never get married!”  Another remarked that “it’s good that you have a nice home because it’s very likely that he will be living with you for his entire life.”  REALLY?!?!?!?!

I have never been a judgemental person.  I teach my children to accept everyone as they are.  God created everyone to be wonderful and He doesn’t make mistakes.  My husband and I try not to make derogatory statements in front of our kids.  Sure, we are not perfect but sincerely strive to teach our kids that bullying others or making judgements about others is not OK.  Some kids have obvious differences, such as my son.  He has a feeding tube and has frequent involuntary eye and body movements.  My good friend’s son has one arm.  Another friend’s son has Down’s Syndrome.  These children have SO much to offer those who get to know them- those who dare to see beyond the physical.  My son is the sweetest child that I have met.  When he sees someone crying, he immediately tries to console them.  He is smart and loving.  He is good at things that interest him.  He WILL change the world someday, and has already changed the lives of those who see beyond the things which make him “different” than themselves.

What about you?  What makes you different than others?  What do you do when you see someone different that you are?  Do you judge?  Do you make comments that may cause pain to others?  Are you aware that variety is the spice of life?  I encourage you to look at your reactions to others, to look at your children’s reactions to others.  What gives any of us the right to say negative things about others out loud or to their face?  You don’t have the right to tell someone that their child will NEVER do ANYTHING.  The fact is, you should not say anything to any mother bear like me who will stop at nothing to ensure that my children have every chance to do what they dare to dream!

Please leave a comment to give me your thoughts….positive or negative….

By- Cara Koscinki MOT, OTR/L 

Author of The Pocket Occupational Therapist- a handbook for caregivers of children with special needs.  Questions and answers most frequently asked to OTs with easy to understand answers and fun activities you can do with your child.  Order anywhere books are sold.  www.pocketot.com 

Sounds and feelings

ChewPocketOTPromoImagine the sound of your mother’s voice.

What memories/emotions does the sound of popping popcorn bring?

Think of the sound of nails on a chalkboard. How about the sound of a bee buzzing near your  head?

Each sound evokes feelings within us.  Sounds are more than just noise.  Human beings make sense of our world from sound.  In fact, there are nerves in our ears which are connected to areas in our brains which involve memory, emotion, fear, and our basic alertness levels (among many others).  This is why we form feelings that are attached to sounds we hear.  What I find truly amazing is that our body remembers sounds to help us to determine if something is safe or dangerous and then our body reacts in response.  When the auditory system develops appropriately, we learn to make responses that fit the sounds we hear.

Remember that children with autism and with sensory integration/processing dysfunctions can have difficulty with forming a response to something that they sense.  When children hear sounds, they form an association.  For most of our children with hearing sensitivity, a loud sound they have heard in the past may have produced a fear reaction or, “fight or flight” response.  These sounds are now perceived as dangerous to them.  So many of my clients fear fire alarms because they are loud and unpredictable.  They have difficulty realizing that the fire alarm is meant to protect them.  In fact, for years my own son was so afraid of the fire alarm in hotels that we had to look in the room before actually booking it so that he could see the type of fire alarm being used.  This is not at all practical!  We simply had no idea how to help him.  The same can be said for any sound that may elicit an inappropriate reaction in our children.  We must try to work with them via a social story, empathy, and understanding to create a new or more positive memory of sound.

-It is always wonderful to do a Google search of pictures of fire alarms (or whatever it is that is making the targeted sound).  Print, glue, or draw pictures in the social story and review it often so that your child will be prepared.

-Several forms of earplugs and noise cancelling headphones are available on the internet.

-Encourage your child to list sounds that cause him to be afraid.  Make a plan for each sound.  For example, when he hears a siren, he can cover his ears, count to ten and take deep breaths.  Practicing in advance will help to give him confidence and lessen anxiety.

-Work with your child’s therapist to form strategies.  Fun CDs like Sound-Eaze and School Eaze are available on Amazon. The CDs have sounds set to gentle rhythm and vocals to help make sounds more tolerable. They are not part of any listening program and are a therapeutic tool.

-Therapeutic brushing and sensory activity diets can also help children to maintain regulation.

-Formal programs such as Therapeutic Listening may be used by occupational therapists to help integrate the sensory system.

Remember that not everyone is going to tolerate loud sounds. Many people simply need to avoid them when possible.

Please share your stories of fear of sound and what techniques you’ve used.

By- Cara Koscinki MOT, OTR/L 

Mom to two children with SPD and autism.  Author of The Pocket Occupational Therapist– a handbook for caregivers of children with special needs.  Questions and answers most frequently asked to OTs with easy to understand answers and fun activities you can do with your child.  Order anywhere books are sold.  www.pocketot.com

5 Tips for Transitioning to Summer Clothing

Summer2012 726While most families look forward to the warm spring weather, there are some of us who look at the transition in weather with anxiety.  Why?  Sensory Processing Disorder may make transitions in clothing from season to season difficult.  Many children have a great deal of fear and worry about moving from long-sleeved shirts to short sleeves or from pants to shorts.  You are not alone if your child is NOT dressing appropriately for the weather conditions outside.  According to the Sensory Processing Disorder Foundation (www.spdfoundation.net) ” 1 in every 20 children may be affected by Sensory Processing Disorder” (SPD).  Sensory dysfunctions can occur in any area (or any sense). The largest organ of the human body is the skin, so chances are great that skin receptors may be affected by sensory issues.

Consider the different textures of clothing and their weight.  Winter sweaters and coats are heavier and provide much more “input” or information to our body’s receptors than a lightweight cotton t-shirt does.  In fact, along with the feeling of touch comes the feeling of pressure and weight that our clothing gives us.  Some children and adults with SPD actually report the feeling of light touch as “painful and like nails on a chalkboard.”  Additionally, when we wear shorts or t-shirts we are able to feel the breeze on our skin- which can also feel “light” and “tickly.”

What can I do to help my child to dress appropriately for the weather?  This is something that I am asked frequently and with every change of season.  In fact, I’ve devoted a portion of my book, The Pocket Occupational Therapist to helping children to tolerate clothing, baths, hair and nail trimming.  PLEASE know that you are not alone!  Many families are having this same issue and feel just as frustrated as you do!

  1. Give your child warning that the seasons are going to change soon.  Explain to him that some days are going to get warmer and some are going to stay cool.  Show him the calendar and mark off the seasons or times in your location when weather typically changes.
  2. Let him go through his drawers with you to determine which clothing he may have outgrown since last summer.  Let him feel the texture, see the color, and choose which clothing he will most likely wear when it’s warm.  Allow him to go shopping with you and have a voice in choosing which clothing is purchased for the summer.
  3. Offer him two choices of clothing/outfits daily.  Giving him control over his clothing can really make him feel in charge of things.  Of course, you can pre-select which two choices you offer to ensure that clothing is appropriate for the weather that day.
  4. Ask him which type of clothing he prefers to wear.  Patterns, textures, buttons, seams, and zippers all matter to children with SPD.  Their existence on a shirt can cause a child anxiety and discomfort.  For example, two summers ago my son absolutely refused to wear any shirts with patterns on them.  So, we purchased t-shirts in all solid colors.  He tolerated the plain shirts well!  The next summer when we went through his drawers he began to cry and show signs of great anxiety.  We realized that he now (a year later) had changed and insisted on wearing only shirts with stripes on them……..it’s like playing detective!
  5. Let him practice before he must actually wear the clothing outside.  Give him a day/time in which he will be wearing the clothing.  Let’s use shorts for example.  “On Saturday, we are going to practice wearing our shorts.  You only have to wear them for an hour and will get a sticker (or some reward).”  Build up the time he wears the clothing  be sure to provide lots of praise and encouragement….this is hard work for him!

The absolute worst thing to do is to force him to wear the clothing that he does not want to wear.  How would you like it if someone made you wear a scratchy wool sweater?  Choose your battles.  Sometimes, it’s better to have a child who is actually dressed rather than one who matches perfectly.  Try to relax and stay calm…..your child takes his cues from you!

We KNOW you can do this….remember that you are not alone.  Let us know how it goes!

By- Cara Koscinki MOT, OTR/L 

Mom to two children with SPD and autism.  Author of The Pocket Occupational Therapist– a handbook for caregivers of children with special needs.  Questions and answers most frequently asked to OTs with easy to understand answers and fun activities you can do with your child.  Order anywhere books are sold.  www.pocketot.com

Dear Bully,

cropped-boyforr2g1.jpgToday you hit my son.  You called him “stupid.”  You said he was a “weirdo.”

It seemed so cool to you to say these things to him in front of your friends.  They all laughed.

Yesterday, you asked a group of children to pummel him with balls during recess.  They all joined in while my son tried to laugh it off.  Yes, you are on a sports team and my son is one of the kids who studies his video games.  He is weak physically compared to you because while you were learning how to toss a ball in your backyard, my son was learning how to speak.  You see Bully, my son was born with autism.  Speech, coordination, social skills, and processing everyday things didn’t come easily for him.  He went to speech therapy two times a week.  He worked in occupational therapy to learn how to eat and chew his food without vomiting.  You were eating all kinds of foods never realizing how much work someone else did to learn to use a fork and spoon.  He spent three months with casts on his feet because his sensory processing issues caused him to walk on his toes and get tight heel cords.  Therapists became his friends because they were who he spent most of his time with.  You were out playing on the playground while my son was sitting on the bench, not knowing the words to say to get other children to play with him.  You were climbing on the monkey bars while my son was conquering his fear of stepping onto the first rung.  His body has trouble processing all of the laughter you and your friends were making.  It sounded painful to him, Bully.  He tried and tried to be like you and when he finally came close and opened up, you said hurtful words to him.  He didn’t expect that.  He expected kindness yet got cruelty.  You looked at him as being weaker than you…….

BUT Bully, I know the truth.  I know how hard my son worked to be “typical” like you.  I know how many dollars were spent on therapy, equipment, weighted blankets, visual aids.  I sat with him as he learned what emotions are.  He watched countless videos on how to make friends.  He practiced over and over and over again with anyone who we could find to play with him….there weren’t many…..He worked to learn to carry on a conversation with you.  He fought through his fear of sounds, sights, and feelings to get into this school with you.  You have NO IDEA what he’s been through.  What his father, sister, brother, and I have been through.  It has not been an easy road.

What you don’t yet see Bully, is that autism is beautiful.  My son is beautiful.  He has qualities that will propel him into wonderful things in his life.  He is bright, sensitive, kind, generous, and a good friend.  He is good at lots of cool things that most kids don’t think about.  His life is a blessing to all of us.  Every baby step he takes is celebrated in our home.  We see him for the unique person he is.

Bully, you think you’re on top now.  I wish you would open your eyes to see differences in everyone.  I wish no harm on you, Bully because someday you may have a child with special needs.  You may have to fight and advocate for your baby like I did- and only then will you truly understand.  I can only pray that your child does not meet a bully like you.

By- Cara Koscinki MOT, OTR/L 

Author of The Pocket Occupational Therapist– a handbook for caregivers of children with special needs.  Questions and answers most frequently asked to OTs with easy to understand answers and fun activities you can do with your child.  Order anywhere books are sold.  www.pocketot.com