Oral-Motor Fun

There are many fun ways to incorporate oral-motor “heavy work” into your child’s sensory diet.  The activities you choose should be fun for your child!  The most important consideration is to choose an activity in which your child is SUCCESSFUL and then make it more difficult as his muscles get stronger.  You wouldn’t want to begin your first ever gym session by lifting a 100lb weight!

Here are a few fun things to try:

-use a straw to blow a cotton ball or small pom-pom

-blow bubbles into a dish pan of water with liquid soap.  Watch your little one laugh when the bubbles form in the water as a result of their hard work of blowing!  *Of course, make sure they don’t drink the water 😉

-hold a cotton ball in your hand or place it on the edge of the table and have him blow it off.  Make a silly sound as it falls

-whistles of all sizes are fun, each differently shaped whistle changes the muscles used by the mouth, so be sure to provide a variety of sizes for super great exercise

-sucking on candy canes of different flavors is a super activity during the holidays.  Not only does it provide work for the oral muscles, but it provides many taste experiences.

-use pixi sticks and place their contents around the child’s mouth at different places, allow the child to use only his tongue to lick it off in front of a mirror

-straws of different sizes can be placed into your child’s favorite drinks

**REMEMBER** the smaller the straw, the harder the oral muscles will work to get the air out.  Begin with a larger, straighter straw and work down to a smaller, curvier one.

Post some of your favorites to share.

Let me know how these activities work for your child!  For more information on oral motor, sensory processing, and anything OT related, purchase our book, The Pocket Occupational Therapist.

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. 

Visit our website at www.pocketot.com for more information about OT, FREE handouts and resource  page.  Also click on the link to the right for more information on our store with downloadable handouts, cards, and lessons for children of all abilities!

The Curse of the SLEEVES

Since I work with (and live with two) children who have sensory integration difficulty I try to have empathy and put myself into their shoes.  I can envision a cockroach in my bedroom or the sound of nails on a chalkboard.  Both examples evoke a physical reaction in me.  So, any information taken in by your senses can cause chills, fear, joy, nausea, etc.  The point of having a sensory system is to get information into your body so it can be processed and then form an outcome.  The outcome can be protective, such as quickly removing your hand from a hot item you’ve touched.  It can be pleasant, such as the fond memories that can result from smelling your mother’s perfume. From the various experiences that we’ve had, we form a memory which can help your body to respond more appropriately or learn from that experience.

Yesterday, I proudly put on my new cottony winter shirt.  As I cut the tags off, I happily thought, “It’s about time you bought something for yourself!”  After feeling quite confident that I would be stylish as I did my errands, off I went!  It was about thirty minutes into my trip that I realized I was getting warm.  After cranking up the A/C, I still felt un-comfortable and a little itchy.   Soon, I tried to push up my sleeves with no success.  You see, they were tapered down  my arm and were going to stay that way-like it or not.  The situation become dire as I felt sweaty, irritated, and a bit nauseous from the lack of control I had over my own body temperature and sleeves!  After hours of this torture, I cut my day short and returned home to throw off this terrible shirt and put it into the Goodwill pile.  Ahhhhh..sweet relief.

Now, I will not be forcing my son to wear anything he doesn’t want to wear.  It’s not because he’s being a “brat” or “difficult” and instead that the clothing that he doesn’t prefer may actually be making him feel sick or uncomfortable.  Think of this situation or your own similar one when you work with or live with someone who has sensory integration difficulty.  Every seam, bump, or roll on clothing may cause an unexpected reaction.  You just never know what someone else is experiencing!

LESSON LEARNED!!

What types of clothing bother 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 

Autism with a side of NORMAL….

On any given day I am like most moms.   I help with homework, do laundry, and tuck my sweet boys into their beds.  To look at  my family, you’d think we are just like everyone else.  Two kids, two cars, decent house, clean clothes, etc.  The difference is what you DON’T see behind closed doors.  My two boys have high functioning autism.  They both look like every other kid in the neighborhood. They love to have fun and are loving children.  However, every little step that they take is not at all without effort.  They both have had extensive hours of speech, occupational, and physical therapy.  I have put voluminous miles on my car going to and from meetings and therapies.  In addition we participate in what’s called “ABA,” which means applied behavior analysis -the use of techniques to bring about meaningful and positive change in behavior.  What this actually means is that we have a team of therapists whose job it is to work with my boys to teach them skills that most children without special needs learn automatically. This may include conversational skills, social skills, or gaining independence with daily living tasks.

We have had ABA for over NINE years.  I have to say that it’s not at all NORMAL to have people following you/your child at home for several hours a week.  I’m not saying that I am opposed to any part of the therapy, but that it is a huge intrusion of our personal privacy and space.  In addition, the therapists come to the store, school, and on any errand that the kids and I go on.  They follow us with a little notebook or clip board and I sincerely feel as though I’m on a reality TV show.  Sometimes, the looks we get from others in public are also very uncomfortable.  Throughout the years I have become used to traveling with an entourage of therapists for the kids.  BUT it never feels comfortable or what I envision “normal” would be.

Being the parent of a child with a disability or special need means that you are automatically traveling on a different path than you had expected.  My husband and I never planned on having this life BUT we would do it all over again if we were asked to.  We have a unique story and experience that has built our character and has enriched both of us.  We have learned that every little thing our boys do has come with great work and teaching.  Every baby step is taken with colossal effort for all those involved.

Our hope is that our boys will be functional and productive members of society.  Most importantly, that they will be happy and feel that they are making a difference in the world.  My husband and I get tired yet feel re-energized when our boys do something that we were told they would NEVER do.  We feel blessed beyond measure to have this life.  To those of you at the beginning of the journey….keep a journal and document where you started.  It is by journaling that you will have a real record of those little miracles.  Sometimes we forget where we came from and it’s a beautiful thing to look back at your original goals and put the word “MET” next to them.  Get support from other caregivers who are going through similar therapy.  You will truly be able to empathize with each other.

The moral of this post….DO NOT MAKE ASSUMPTIONS based on appearances. Our NORMAL looks quite different than your NORMAL.  Wait, there’s no such thing as NORMAL!!!!

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 

Eosinophilic Night Before Christmas

Eos Night Before Christmas

          ©Cara Koscinski

  ‘Twas the night before Christmas, when all through the house     

The pump was a whirring, and waking the mouse;

His feeding bag was hung by his bed with care,

In hopes that some nutrition soon would be there;

The children were nestled all snug in their beds,

While visions of eating real food danced in their heads;

G and NG Tubes, each with their caps,

If they’re open, they’ll leak and disturb my kid’s long winter’s  nap;

When the pump started beeping, there arose such a clatter,

I sprang from my bed to see what was the matter.

Away to his side, I flew like a flash, Tore open the covers – saw a kinked line and a rash….

I think of the time that he could eat food.

When people didn’t judge us, some are just rude.

The cakes, cookies, and foods that he cannot eat.

The dream of giving my boy just one food treat,

Has vanished and won’t come back very quick,

No one can cure it, not even St. Nick.

More rapid than lightning the vomiting came,

Eosinophils cause this disease, EGID is the name.

In Greenville, Colorado, Pittsburgh, and Philly!

In Boston, in Texas, in Florida, in Cincinnati!

They work on research, so our kids can grow tall!

Now find a cure today! Please we pray!  Work together all!

Dreams of having a typical childhood away fly,

Because of this disease, our children must cry.

Vomiting, pain, diarrhea, and choking,

ulcers, fatigue, another doctor-are you joking?

Enemas, laxatives, surgeries, scopes,

Steroids, tests, biopsies, IVs-yet our kids have hope!

Just when you think this disease has calmed down,

Our kids are faced with another re-bound.

Insurance won’t pay for his special food,

We must fight for everything, we hate to be rude;

A pump and some formula flung on his back,

And another day goes by with him wearing his pack.

His eyes — how they twinkle! His laughter– how merry!

He cannot take even one taste of dairy!

Just a little bit of food he can’t chew with his teeth,

We must steal food away from him like a thief.

One or two safe foods, we learn to cook.

Expensive food stores, all of our money, they took.

Someday he’ll be chubby and plump, like a jolly little elf,

And I’ll laugh when I see him, in spite of myself;

Until then, we all will continue to fight…..

“Merry Christmas to all, and to all a good-night.”

© 2011  Shared with permission

Thanksgiving Thanks from Tom Turkey

This Thanksgiving is another special one.  We are blessed to have our family together.  We are blessed that our children have a special nutrition to drink/be fed that is safe and totally hypoallergenic.  Tom the Turkey is especially happy that we saved him this year.  We won’t be purchasing a turkey because our children are both allergic to it.  I’m not opposed to eating turkey and plan on joining our friend’s family for the holiday. But, in our home the smell of g-tube food and Dum-Dum lollipops will prevail.

We are thankful for each precious moment with our children.  It’s not easy to raise children and is even more difficult when they have special needs.  God has blessed us with the opportunity to learn how to use sign language, feeding tube, PECS, and behavior charts.  We have met wonderful therapists, friends, and other parents who have children like ours.  Facebook and blogging have brought us even more helpful connections.  Indeed, we have MUCH to be thankful for.

HAPPY THANKSGIVING from Route2Greatness to your family!!

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 

Tips for Preparing For School

School Days

School already?!?!  Yes, it’s that time of year.  When I saw that first back to school commercial, the anxiety of preparing for school came upon me.  I knew that the transition from shorts to pants, from casual dress to uniform, from free-time to structured learning was approaching quickly.  It seemed as though I just transitioned the kids into summer activities and they were finally comfortable with the routine.  No matter, school and end of summer arrives whether we (and our children) are ready or not.  This is life-transitions are always approaching-some are easy while some aren’t.

Never fear!  The Pocket Occupational Therapist is here with some tried and true suggestions for your family.  Anxiety comes from not knowing what is coming ahead.  Giving your child control of anything possible is a good way to build confidence and decrease worry.

1) Lay out pants, dress shirts, or school uniforms at least three weeks before school.  Habits can take at least 21 days to be broken.  Allow your child to shop with you and make choices if possible about school attire.  Often times, uniform material is much more stiff and “pinchy feeling” than lighter summer clothing.  Make a schedule and encourage your child to wear school clothing for a brief time each day and gradually work up the time.  Be sure to offer a reward for a job well done!  Having another child such as a sibling or friend complete this activity with your child can be especially fun.

2) Do not wait until the last-minute to purchase school supplies.  Take your child to the store and allow him to make choices of color of notebooks, folders, brand of pencils, etc.  Any choice you are able to give your child encourages feelings that he’s in control of the situation.  This is important as so many aspects of school are beyond his control.

3) Ask your child to help you to label items.  This is a good way to practice writing his name.  Allow him to  choose the color of the marker.  Use of an “old-fashioned” label maker is a good way to increase hand strength.  Squeezing the tool can work those hand muscles.

4) Obtain the daily school schedule and post it on the refrigerator or a centrally located area.  Review the schedule daily and use words such as, “It’s 9:00 now.  When you are in school you will be in reading class with Mrs. Jane.”  Do this frequently throughout the day.

5) Begin to practice handwriting and keyboarding with your child. Have him help you to make the grocery list, daily schedule, or write cards to relatives.  Making handwriting fun is important to build confidence and strengthen those hand muscles in preparation for school.

6) Begin bedtime routines at least three weeks prior to school.  It won’t be easy so do not fret!  Gradually work up to the desired bedtime and make a written “wind-down” schedule of activities that are calming and the bed time routine.  Allow your child to help make the schedule and give rewards for every little success.  Use calming music, massage, and soothing scents in the bath to encourage the body and mind to relax.

7) Meet with your child’s teacher prior to the first day of school.  A trip to his classroom with a camera is an excellent preparation activity.  Allow him to take pictures of the classroom, desk, cubby/locker and make a scrapbook of his school and room.  We had a child who was extremely fearful of the fire alarm/drill in the classroom.  We permitted him to take pictures of the fire alarm and used the Sound-Eaze and/or School -Eaze CDs to listen to the sounds of fire alarms.  Giving him the heads-up of what sounds to expect was a good tool to decrease his anxiety of the un-known.                                                                                                                         Some schools have summer camps.  If the school permits it, allow your child to sit in on a camp day/class to get used to the noises and bustle of the classroom.  The more preparation you can give your child, the more likely he will be to make a successful transition into the classroom.

8) Encourage your child that he should try his best and that he does not have to be perfect!  Mistakes are the best way to show that your child is trying.  Review errors with him and encourage him to problem solve.  Many of my clients believe that their child is trying his best, but often get too busy with life’s events to take time to reward for the good qualities and times when children succeed.  We fill out repeated questionnaires asking what our child’s weaknesses are that we often forget about their strengths.

What activities does your family have to prepare for school?  Let us know!!

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 

What is a "stim" or stimulatory behavior in autism?

We have heard of “stims” or stimulatory behaviors in children with autism.  It is one of the signs doctors look for in making a diagnosis of autism.  Stereotypic or stimulatory behaviors include rocking, flapping, making noises, picking, rocking, or spinning.  In fact, we all have behaviors that are considered stimulatory.  What do you do when you are in a stressful situation to calm yourself down?  Some people twirl their hair, chew their fingernails, or tap their fingers on the table.  So, everyone has some behavior that is calming.  So, what is the difference between you and a person with autism?  The ability to determine the “social acceptability,” duration, and timing of the behavior is the key.  In a meeting when you are stressed it is not appropriate to flap your hands wildly, twirl around, or make clicking or humming noises.  You have learned that biting your fingernails or bouncing your leg is an acceptable way to deal with stress.  Chewing gum or ice is another acceptable way to self-soothe in public.

Most people with autism also have some form of sensory processing disorder.  This means that everyday noises, sights, smells, movements, and actions may cause a stress, fear, or un-expected reaction.  The noise of a dog bark may sound like nails on a chalkboard. So, that person may need to engage in a stimulatory behavior in order to calm himself down.  The “stim” is a way of soothing in a stressful situation, controlling negative emotions, or dealing with anxiety, anger or fear.  So, when someone is hyper(over) sensitive to everyday situations, sounds, sights, etc.  he needs to engage in more stimulatory behaviors to help calm himself down.  It’s like a cycle.

When do we “break” the cycle?  Personally, I think that our society makes rules that are difficult to follow.  Why is it more acceptable to chew on your fingernail than to flap your hands?  At what point is it no longer cute for a child to spin around in public?  Someone, somewhere is constantly judging your actions and it’s that mold that we have to fit into that causes more stress.  My older son makes noises with his mouth and flaps and tightens his hands in private only.  We have taught him that it is inappropriate to do so in public.  When he is stressed in a situation, he knows to go into a bathroom or away from eyesight of other people and stim until he’s calmed down.

This is much more difficult to teach children who have more severe forms of autism.  When they may rock and flap, they get the staredown from people.  I think this is sad.  With autism on the rise, maybe the ones who rock and flap will outnumber those who don’t!  Can you imagine????  Everyone else flapping around staring at YOU because you are the one standing still chewing your gum and biting your fingernails………….thoughts?

Thank you for traveling down the Route2Greatness with us!  www.route2greatness.com

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 

The Power of a VISUAL..Happy New Year!

Few things excite us and cause a feeling of starting new and fresh like New Years holiday.  It signifies a new beginning.  The visual image of the ball dropping on midnight is so powerful that people make resolutions to make actual changes to their lives.  Imagine that!  What’s the actual difference between today and tomorrow, nothing.  We aren’t different, our lives aren’t different.  We don’t see the time changing in reality…..BUT……the visual symbol of the ball and the change in the calendar carries real POWER.

I encourage you to examine your own reactions to the New Year-wheather they are positive or negative.  Then, look at your child who is a visual learner.  WoW!  The visual stories that you can create to help your child have the potential to create REAL change to their daily lives.  Giving a visual along with your verbal praises, directions, and emotions can be a great help!  The visual image you assign can help your child immensely.  I have made a great many social stories for clients (and my own children) and have seen big changes in their ability to transition and complete activities of daily living with greater ease.  We all need visuals from time to time and don’t think much about them in our own lives.  We all experience the changes that come with New Year’s Day and I’m hoping that you take a minute out of that day to reflect on your child and the potential you have to make a positive difference in his/her 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 

Happy VISUAL New Year to All!

Wishing you many blessings in 2013……..from your friends at The Pocket Occupational Therapist.

Eos Night Before Christmas

          ©Cara Koscinski

 

  ‘Twas the night before Christmas, when all through the house
     The pump was a whirring, and waking the mouse;

 
His feeding bag was hung by his bed with care,
In hopes that some nutrition soon would be there;

The children were nestled all snug in their beds,
While visions of eating real food danced in their heads;

 G and NG Tubes, each with their caps,
If they’re open, they’ll leak and disturb my kid’s long winter’s  nap;

When the pump started beeping, there arose such a clatter,
I sprang from my bed to see what was the matter.

Away to his side, I flew like a flash,
Tore open the covers – saw a kinked line and a rash….

I think of the time that he could eat food.
When people didn’t judge us, some are just rude.

The cakes, cookies, and foods that he cannot eat.
The dream of giving my boy just one food treat,

Has vanished and won’t come back very quick,
No one can cure it, not even St. Nick.

More rapid than lightning the vomiting came,
Eosinophils cause this disease, EGID is the name.

In Greenville, Colorado, Pittsburgh, and Philly!
In Boston, in Texas, in Florida, in Cincinnati!

They work on research, so our kids can grow tall!
Now find a cure today! Please we pray!  Work together all!

Dreams of having a typical childhood away fly,
Because of this disease, our children must cry. 

 Vomiting, pain, diarrhea, and choking,
ulcers, fatigue, another doctor-are you joking?

Enemas, laxatives, surgeries, scopes,
Steroids, tests, biopsies, IVs-yet our kids have hope!

Just when you think this disease has calmed down,
Our kids are faced with another re-bound.

Insurance won’t pay for his special food,
We must fight for everything, we hate to be rude;

A pump and some formula flung on his back,
And another day goes by with him wearing his pack.

His eyes — how they twinkle! His laughter– how merry!
He cannot take even one taste of dairy!

Just a little bit of food he can’t chew with his teeth,
We must steal food away from him like a thief.

One or two safe foods, we learn to cook.
Expensive food stores, all of our money, they took.

Someday he’ll be chubby and plump, like a jolly little elf,
And I’ll laugh when I see him, in spite of myself;

Until then, we all will continue to fight…..

“Merry Christmas to all, and to all a good-night.”

 © 2011  Shared with permission

VISUAL learners

Anytime I ask my son with Aspergers to tell me about a feeling, thought, or idea he consistently gives me a visual picture.  It never ceases to amaze me at how he thinks of things.  Today we were in our therapy session and he was told to talk about his family and draw them as animals.  He incredibly drew accurate animals complete with expressions.  The reasoning behind why he drew the family members as the animals was truly AMAZING.

Himself:  A loving puppy dog.  Mother:  A robin with a nest of three eggs:  one for he and his brother, one for his “dream sister.”  “The  mother never leaves the birds hungry, always protects them, and teaches them how to fly”……AMAZING.  How about his aunt, who he drew as a bluebird (not blue jay, because they can be mean).  Blue for her favorite color and she’s another bird, who protects her young.  Finally, his brother as a cat.  They fight like a cat and a dog but can cuddle and love too.

I remember seeing Temple Grandin speak a few years ago and she verbalized that her learning is translated into a file of sorts in her brain.  For instance, a steeple is categorized in a file as compared to the very first steeple she saw as a child.  Her file for steeple is constantly being added to and changed, but all steeples compare to that very first one she saw.

Parents, therapists, and teachers….I implore you to think of your child’s visual learning as a strength.  Use this wonderful skill to truly understand your child’s wonderful view of this world.  I promise, that it will truly amaze you and you WILL be blessed and touched at how completely organized and visually explosive his view of the world really is!  What a true blessing it is to be around someone who thinks in pictures!!

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