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 

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

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 

He has a disability so he will never….

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.  One person very close to me said, “Great, well this means he will never get married!”  Another remarked that it’s good that we have a big home because it’s very likely that he will be living with us 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 

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.

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 

 

Ready for school?

It’s that time of year when the kids are full of excitement, parents are working on getting the routine back up and running, and teachers are busy decorating their rooms and planning lessons!  I can still remember the song on a TV add for back to school days and the mixed feeling of dread and excitement it brought to me.

To our children with sensory integration dysfunction, the beginning of school can mean much more than anticipation and excitement.  It may signal the “fight or flight” response.  This means that something about school may cause the feeling of great anxiety.  It may be the smell of the room, noise of the school bell, a situation that happened last year, or the feeling of establishing a new comfort zone.   Our children may experience greater physical symptoms of anxiety and more “stimming” or self-regulatory behaviors surrounding school.  My older son has a marked increase in his verbal high-pitched noises throughout the day since my announcement of beginning our back to school bedtime routine on August first.

The most important thing we can do as parents of children with special needs is to help ease the transition of back to school.  Here’s the list that I’ve made as a result of years of personal experience coupled with the observation of the parents whose children have come to me for therapy:

1)  Try to schedule a visit to the school when all is quiet.  This is a super idea even for a typical child with anxiety about school.  While at your visit, allow your child to take pictures of the classroom, desks, the teacher, and any area where transition is required such as the gym or cafeteria.  If at all possible, find out who the teacher is and schedule ten minute meeting to take his/her picture with your child. 

  **The second step is to make a colorful binder with the pictures taken at school.  Involving your child is an essential step in this activity.  In the binder the classroom rules could be included.

Our School-Eaze CD contains many school sounds such as school bell, cafeteria noise, gym class, swim meet, and hallway noise/change classes.  The sounds are set to rhythms.  Allowing your child to control the volume of the sounds is important to help him/her to feel more in control. Visit www.route2greatness.com for more information.

2) Begin  the bed-time routine at least two weeks before school starts.  This should include making sure the backpack is by the door, clothes are set out, and any bed time prayers/devotions are said.  If at all possible, sleep routine should be set so that getting up early on the first day of school is not so difficult.

3) Pack the packpack with the familiar items and let your child play with them, making sure to replace them afterwards.  Label folders as appropriate and practice repeating phrases that your teacher would use.  “Students, please get out your pencil, markers, and the history folder please.”  This is also an excellent way to practice following single and multi-step commands.

4) Write the classroom routine down and review it daily.  This is an especially important step with older children who may be changing classrooms or utilizing lockers.  Our routine is spelled out with a schedule from getting up to getting out of the door, and then following a seperate school schedule.  If an entire schedule is completed, then a star is given at the top of that schedule by the supervising adult.  You may break tasks down as appropriate for your child, but reviewing the classroom schedule each day at least two weeks before school begins is important.

More ideas for homeschooling, transitions, activity charts to come!