Monday, October 31, 2011

Clothespin Spiders

Happy Halloween!

There's no denying it...pediatric OTs love clothespins! Here's a fun fine motor idea for Halloween.
I got this great idea from a happy wanderer (please check out her blog for more great ideas).
These are the super-cute and creative spiders that she made:

And this is how I adapted the activity for my students:

1. Color a paper plate (my student quickly pointed out that it would be easier to paint the plate). A flat paper plate or black card stock would probably work better, but I was using what I had on hand.
2. Cut out shapes (I used orange circles and squares and white ovals for the eyes).
3. Glue the orange shapes to the plate (four on each side)
4. Color the eyes and glue them to the plate
5. I drew shapes on the clothespins and on the orange shapes and then had the student match the shapes to make the legs.

What are your favorite clothespin activities?

Friday, October 28, 2011

Sensory Tips for Halloween

Halloween can be a challenging holiday for children with sensory difficulties. Below are some tips to help make the holiday more fun for everyone!

Pumpkin Carving:
Pumpkin carving can be a great tactile activity for sensory exploration, or it can be an uncomfortable experience for children with tactile defensiveness. Try the following adaptations to make it more enjoyable for all.
  • Let your child wear plastic gloves. 
  • Put the pumpkin ‘goop’ into a Ziploc bag and let your child explore it through the bag.
  • Use a spoon to scoop the goop, to avoid touching it with bare hands.
  • As with all tactile activities, don’t force your child to touch anything he doesn’t want to touch.
  •  Involve your tactilely defensive child by letting him participate in a different way, such as drawing a face on the pumpkin.

Halloween Parties:
  • Plan ahead.  Ask the host or teacher what will be happening during the party, so you can prepare your child. Use a social story to prepare your child.
  • Find a quiet place that your child can use to take a break.
  • Offer to bring a snack to share that your child will enjoy.
  • Use the costume tips below.

  •  Let your child help choose the costume. Take into consideration the feel of the fabric and your child’s preferences.
  • Have your child wear the costume prior to Halloween to get accustomed to how the costume will feel.
  • Wear tight clothing underneath the costume.
  • Don’t force your child to wear face paint. Wear a mask instead, or go without anything on your child’s face.
  • Consult with your child’s occupational therapist to determine if placing weights in the pocket might be beneficial.

Trick or Treating:
  •  Plan ahead. Walk through the route with your child you will be taking prior to trick or treating
  • Trick or treat in a familiar neighborhood. Consider going before dark and avoiding houses with scary music and flashing lights.
  • Participate in calming, “heavy work” activities prior to trick or treating (i.e. jumping jacks, animal walks)
  • Remember, it’s ok to go home early!

For more tips, check out AOTA’s Tip Sheet: Enjoying Halloween with Sensory Challenges

Have a safe and fun Halloween! What do you do to make Halloween more sensory-friendly?

Wednesday, October 26, 2011

World Occupational Therapy Day

Tomorrow, October 27th is World OT Day. Check out the World Federation of Occupational Therapists for more information about Occupational Therapy around the world.

Online Technology 4 Occupational Therapy is hosting a 24 hour Virtual Exchange, which has a line-up of speakers from New Zealand, Canada, United Kingdom and United States.

Linda, over at Linda's Daily Living Skills, is hosting an OT Blog Carnival. Please check out her blog, as well as all of the other great OT blogs.

Monday, October 24, 2011

Occupational Therapy in Early Intervention

“But my baby doesn’t have a job, what are you going to do for my child?” I think all pediatric OTs have heard a comment similar to this one at some point. Today, I’d like to focus on the role of OT in early intervention. This is based on my experiences working in early intervention in the state of California. I’m sure it varies by region.

Occupational therapists working in early intervention (birth to three) provide services under IDEA Part C to children with developmental delays. Occupational therapists work with the family and infant or toddler in the natural environment to promote function and engagement in everyday routines, such as mealtime, play and social development. The natural environment may include home, daycare and community settings. In my experience, services typically take place in the home or daycare setting.  Services do not always occur in the natural environment. The company I work for also has a clinic, with a great therapy gym, which is used for some clients for a variety of reasons (e.g. parent preference, access to specialized equipment, shortage of OTs). To give you an idea of what occupational therapy addresses in early intervention, I’m including a breakdown of a typical day for me.

Here’s a breakdown of a typical day for me:
8:00 – Check and respond to email; check voicemail/text messages for cancellations (I primarily use email and text messages to communicate with parents about scheduling/questions)
8:15 – Travel to first home
8:30-9:30 – Provide treatment to 2 ½ year old child with global developmental delays, focusing on gross motor acquisition and pretend play skills
9:30 – Travel to second home
9:45-10:45 – Provide treatment to 10 month old with motor delays/high muscle tone. He shows off his new skill of crawling all over the place!
10:45 – Travel to third home
11:15-12:15 – Provide treatment to 20 month old child with a genetic syndrome and cortical vision impairment, focusing on locating toys by sound and sitting independently
12:15 – Grab a quick bite (usually in my car) and travel to next home
1:00-2:00 – Provide treatment to 18 month old with a chromosomal disorder, focusing on eating skills, especially chewing/accepting solid and textured foods
2:00 – Travel to fifth home
2:30-3:30 – Provide treatment to 16 month old with a global developmental delays, focusing on sitting independently and developing postural righting reactions
3:30 – Travel to last home
3:45-4:45 – Provide treatment to nearly 3 year old with autism. Lots of discussion with parent about community resources (e.g. gymnastics classes) and various preschool options (e.g. public school, Montessori, Kumon Learning Centers) as the child transitions out of early intervention services at age three. He has worked hard to increase the number of foods he will eat and he shows me his new food for the week: avocado!

This is a full, but smooth day (when no one is sick or cancels). I either do paperwork in the evening or on another day (when I have time built into my schedule to do so). I absolutely love working with families and their children in early intervention. Each child and family is unique and I always have new and exciting challenges each day.

I would love to hear about the experiences of other occupational therapists working in early intervention! Or the experiences of families receiving occupational therapy through an early intervention program!

Environmental factors in autism

It seems like everywhere I look, there is more research to support a link between environmental factors and autism. Over the summer, a twin study was published, in which it was discovered that twin siblings have a higher rate of autism than their non-twin siblings. This indicated that environmental factors play a role in autism. Here's a link to a New York Times article which explains the results of the study in easier to understand terms.

I just read about a Norwegian study that found that taking folic acid supplements prior to pregnancy decreases the chance of the child having a severe language delay at age three. As we all know, language delay is one of the main indicators of autism. 

Recently, an American study found that taking prenatal vitamins 3 months before and one month after pregnancy led to a decreased risk of autism.

Friday, October 21, 2011

Sweet and Salty Pumpkin Seeds

It's pumpkin carving time! This is another fun activity for Halloween. Pumpkin carving is great for tactile exploration and then the little ones can help turn the pumpkin seeds into a crunchy snack.

Recipe for Sweet and Salty Pumpkin Seeds:
What you will need:
  •  seeds from one medium sized pumpkin (approx. 1 cup)
  • one tablespoon of butter (melted)
  • 2 tablespoons of sugar
  • 1 teaspoon of sea salt
  • 1/2 teaspoon of cinnamon

First, carve your pumpkin and pull out all of the goop and seeds

Next, separate the seeds from the goop
Then rinse the seeds in water to remove the remaining pumpkin goop

Now it's time to make some sweet and salty pumpkin seeds!
Mix the butter, sugar, salt and cinnamon together to make a paste
Then toss the pumpkin seeds with the mixture (it helps if you let the pumpkin seeds dry out first)

Now spread the coated pumpkin seeds out on a baking sheet and bake for 20-30 minutes at 275 degrees. Be sure to keep an eye on the pumpkin seeds and to stir them often, so they don't burn.
Enjoy your sweet and salty baked pumpkin seeds!

And don't forget to finish carving your pumpkin!
Happy Halloween!


Wednesday, October 19, 2011

Dirt and Worms

Dirt and Worms is a fun activity for Halloween. I believe that food should be fun and during feeding therapy, I like to show kids how food can take different forms. In this recipe for Dirt and Worms, we crush the cookies with a rolling pin to make cookie crumbs. This recipe can be great for sensory exploration of a variety of textures (sticky gummy worms, wet pudding, dry cookie crumbs). I also like to use a Fun Chop Chopstick Helper to promote fine motor skills.

Dirt and Worms Recipe

What you will need:
  • chocolate pudding cup (you can also use instant pudding)
  • Oreo cookies (I used mini Oreos, but regular size will also work)
  • gummy worms
  • sandwich bag
  • rolling pin 
  • Fun Chop Chopstick Helper (optional)
Step 1: Scoop the pudding into a small bowl

Step 2: Place the cookies into the plastic bag

     optional: you can use the chopstick helper to complete this step

Step 3: Crush the cookies with a rolling pin

Step 4: Place the worms in the cup of pudding (again, you can use the chopstick helper if you want to work on fine motor skills)
Step 5: Pour the cookie crumbs on top of the pudding and worm mixture


Here are some other fun chopsticks:
Chimpsticks Chopsticks 
Happy Man Chopsticks
And the OT favorite: Zoo Sticks

Tuesday, October 18, 2011

No TV under age two

The American Academy of Pediatrics released their TV viewing recommendations for children today. They continue to recommend little to no TV or screen time for children under age two. They state that video screen time provides no educational benefits to children under age two and that infants and toddlers need face to face interaction to learn and develop language skills. Check out this article for more information on the recommendations.

I think it would be interesting to also look at the impact of caregiver's screen time on children under age two. I would guess that children of parents who are busy checking emails, texting, tweeting, blogging, etc, are not getting as much face to face interaction or hearing as much language as children whose parents spend less time looking at screens.

Monday, October 17, 2011

Some of my favorite sensory books

In celebration of National Sensory Awareness Month (and my love of reading), I would like to share some of my favorite sensory books with you. Most are geared toward parents, but I have also found them to be helpful to me as an OT. 

Raising a Sensory Smart Child by Lindsey Biel, OTR/L & Nancy Peske
This book, co-authored by an occupational therapist and a mother of a child with sensory processing disorder, is a wonderful resource full of tips for nearly every situation a child with sensory issues could encounter (e.g. washing hair, wearing eyeglasses, dentist appointments). This book also explains sensory processing in parent-friendly terms, and discusses other issues, such as autism, picky eating and advocating for your child. I would say that this book is a must-have for parents and pediatric occupational therapists. Check out Linday's website SensorySmarts for tons of helpful information about occupational therapy, sensory processing disorder, and sensory tips.

Sensational Kids: Hope and Help for Children with Sensory Processing Disorder by Lucy Jane Miller, PhD, OTR
This is another go-to book for parents, as it puts sensory processing into very easy to understand terms. Written by Lucy Jane Miller, founder of the Sensory Processing Disorder Foundation, this book provides of wonderful overview of sensory processing disorder and is full of case studies that illustrate how sensory processing disorder presents in different children.

The Out of Sync Child Has Fun by Carol Stock Cranowitz, MA
This book is a  companion to The Out of Sync Child. Honestly, I have never read The Out of Sync Child, but I'm sure it is as wonderful as its companion. I've flipped through The Out of Sync Child, and it appears to be similar to the first two books listed above. The Out of Sync Child Has Fun is full of sensory activities that parents can carry out at home. Check out Carol's website for more information about her books and upcoming speaking engagements.

Tools for Tots by Diana Henry, MS, OTR/L, Maureen Kane-Wineland, PhD, OT/L & Susan Swindeman, OTR/L, BCP
As an occupational therapist working in early intervention, I often refer to this book and share it with parents. This book provides a brief overview of sensory processing disorder and checklists for parents. The book is then divided into a variety of topics, such as Sensitive Ears, Tippy Toe Tots, Busy Bees, Picky Eater Tidbits, Tooth Brush Tamers, Nail Nippers, and Tubby Time Tips, with a "sensory buffet" of activities for each topic. A great resource for anyone who works in early intervention or a preschool setting.
Check out Diana Henry's website for more information about her other books, as well as a schedule of her workshops. She is also a co-author of the Sensory Processing Measure, which I don't use, but probably should, based on what I've heard about it :)

What are your must-have sensory books?

Friday, October 14, 2011

In my therapy old bicycle tube

In this era of shrinking budgets, it pays to get creative with supplies. I can't remember where I first heard about doing this, but an old bicycle tube is a great replacement for Theraband. I often tie Theraband around the legs of a classroom chair for the student to kick into to get proprioceptive input while sitting. This allows the student to fidget and receive sensory input, which can help with the student's ability to focus, concentrate and most importantly, remain seated. This also works well for fidgety children who can't sit still at the dinner table long enough to get through a meal with their family.

A used bicycle tube is a great replacement for the more expensive Theraband. It provides the same sensory input and it's something that a teacher or parent can obtain on their own, so they don't feel intimidated by the occupational therapist's specialized supplies. As you can see in the pictures below, I just tied an old bicycle tube around the legs of a classroom chair.

Now it's time to head out to your local bike shop and ask for their old bicycle tubes! I have found that they are happy to give them away, as they are just going to throw them in the trash. It's a great way to recycle and save money!

Wednesday, October 12, 2011

Fall Leaf Fine Motor Craft

This is one of my favorite fall crafts, promoting fine motor skills and the coordination of both hands. It can also be used to work on scissor skills, if you have the child cut out the leaf and tissue paper.

What you'll need:
Tissue paper cut into 1 1/2"-2" squares
Leaf template (like this one)

 Step 1: Fold a square of tissue paper over the end of a pencil

Step 2: Put a little glue on the tissue paper

Step 3: Press the tissue paper onto the leaf

Final Product! Great for decorating a classroom or therapy clinic!

Tuesday, October 11, 2011

California passes SB 946

California became the 28th state to enact autism insurance reform on Sunday when Governor Brown signed SB 946 into law. The law will go into effect July 1, 2012 and will require coverage of proven behavioral therapies.

The AOTA September/October Scope of Practice Issues Update stated that occupational therapists will be included as a qualified autism providers under this law. It will be interesting to see how this law changes the provision of services for children with autism in the state of California and how it will impact occupational therapists. I know I will be following the implementation of this law closely.

Check out Autism Votes for more information about SB 946 as well as this article in the LA Times: Autism treatment law again shows insurers' need for therapy

Monday, October 10, 2011

SmartKnitKIDS Seamless Sensitivity Socks

SmartKnitKIDS has a great line of seamless socks for those sensory kiddos who just can't tolerate wearing socks.

Professionals can request an Educational Kit, which comes with a sample pair of SmartKnitKIDS socks and informational brochures to hand out to parents.

The socks are a tube shape, so there is not a seam at the heel.
As you can see in the picture below, the SmartKnit sock (on the top) is nearly seamless, compared to the regular sock (on the bottom).

Here is a close-up of the toes (on my hand, because I couldn't fit into the kids XL :)
And here's a close-up of a regular sock:

The prices start at $6.95 for a pair of children's socks, which seems a little pricey, but if you have a child who truly cannot tolerate wearing socks, it is probably money well spent.

SmartKnitKIDS also carries socks for big kids, seamless AFO socks, seamless undies, and seamless undertees.

***I am in no way affiliated with SmartKnitKIDS. I just think that they have a unique product that more people should know about.

Friday, October 7, 2011

The Misunderstood Child

The Misunderstood Child
A poem about children with hidden disabilities
by Kathy Winters

I am the child that looks healthy and fine. I was born with ten fingers and toes. But something is different, somewhere in my mind, And what it is, nobody knows.

I am the child that struggles in school, Though they say that I'm perfectly smart. They tell me I'm lazy -- can learn if I try -- But I don't seem to know where to start. 

I am the child that won't wear the clothes Which hurt me or bother my feet. I dread sudden noises, can't handle most smells, And tastes -- there are few foods I'll eat.

I am the child that can't catch the ball And runs with an awkward gait. I am the one chosen last on the team And I cringe as I stand there and wait.

I am the child with whom no one will play -- The one that gets bullied and teased. I try to fit in and I want to be liked, But nothing I do seems to please. 

I am the child that tantrums and freaks Over things that seem petty and trite. You'll never know how I panic inside, When I'm lost in my anger and fright.

I am the child that fidgets and squirms Though I'm told to sit still and be good. Do you think that I choose to be out of control? Don't you know that I would if I could?

I am the child with the broken heart Though I act like I don't really care. Perhaps there's a reason God made me this way -- Some message he sent me to share.

For I am the child that needs to be loved And accepted and valued too. I am the child that is misunderstood. I am different - but look just like you.

***Thank you to Kathy Winters for allowing me to reprint her poem

Wednesday, October 5, 2011

Sensation Celebration

October is.....
National Sensory Awareness Month!

For more information, check out The Sensory Processing Disorder Foundation and these great links:
Sensational Kid - Do You Know Me?
Red Flags of Sensory Processing Disorder

In honor of National Sensory Awareness Month, I will be posting information relating to sensory processing throughout the month.

Monday, October 3, 2011


Welcome to my blog! I am a pediatric occupational therapist, specializing in school-based and early intervention therapy, with a strong interest in feeding therapy. I have created this blog to share resources, ideas, news and general information for pediatric occupational therapists. Please visit often and share your comments and ideas!

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