Monday, October 29, 2012

Toothbrush Timer App

Visual timers can help with compliance and task completion, especially in children with autism. I just came across Toothbrush Timer, which is a basic visual timer app for a specific activity - tooth brushing!  
This app runs for two minutes, with 30 seconds for each quadrant of the mouth. It provides a visual cue for which quadrant of the mouth to brush and even breaks each quadrant into outside, top, and inside, as you can see in the screenshots below. That level of precision might be difficult for some children to understand, but I think it is still useful if the child just brushes each quadrant for the desired time.

After the 30 seconds are up, the app makes a beep and then the next quadrant is highlighted. When the timer runs out completely, there is an applause, which might serve as a motivator for some children.

App Information

Name of App: Toothbrush Timer
Publisher: Ryan Newsome
Compatible with: iPhone, iPod Touch, and iPad. Requires iOS 4.2 or later.
Price: Free from the Apple iTunes App Store.

Information was correct at the time of publication of this review, but is subject to change, so please confirm prior to downloading.

Have you had success with this app? What other apps to you find helpful for completion of self-help tasks?

Saturday, October 27, 2012

World OT Day 2012

Today is World Occupational Therapy Day! A day to celebrate and promote the profession of occupational therapy. This year's theme is "Exploring Balance", a topic that we should all take some time to reflect upon in this busy world.

In honor of World OT Day, Linda, of Linda's Daily Living Skills, hosted the 2nd Annual World OT Day Blog Carnival. Stop by her blog to read how some OT bloggers (including myself) are exploring and finding balance.

Online Technology 4 Occupational Therapy is hosting a 24 hour virtual exchange, with OT's from around the world discussing the theme of exploring balance. Click here to learn more and to see the schedule.

The World Federation of Occupational Therapists is holding a photograph competition to visually capture the work that occupational therapists do around the world. The theme is "All in a day's work" and I can't wait to see the great photos that come from this competition. The competition is open until May 13, 2013, so that is plenty of time to get a great photo for submission (and permission from any client's in the photo).

Happy World OT Day!

Friday, October 26, 2012

Five Friday Features

First things first. Drum roll, please....And the winner of the $50 Educational Insights Giveaway is.....Carrie Hager! Congrats, Carrie! Please send me an email so I can get your prize to you!

Not the winner? Don't despair! Thanks to the generosity of Educational Insights I will be hosting more giveaways soon, so be sure to check back!

1. I received my copy of Dark and Light: A Love Story in the mail this week! I'm so happy to see Shasta's book in print and so proud of what she has accomplished! Way to go Shasta!

2. The October newsletter from Tots-N-Tech is a great one! The topic is Using Visual Supports with Infants and Toddlers. The newsletter defines visual supports, helps you decide which type of visual support to use, and then gives examples and how-to's on making a variety of visual supports, from social stories to visual schedules to choice boards and more! What a fantastic resource! Click here to view the newsletter (it is a PDF file).

3. Love, love, LOVE these DIY travel size chalkboards from No Time for Flashcards. The tactile feedback that chalkboards provide are great for teaching letter formation.

4. On Wednesday I attended an in-service at work about Michelle Garcia Winner's Social Thinking. I'm very excited to implement some of the concepts I learned with my students! It should tie in nicely with concepts from The Hidden Curriculum.

5. I recently started a new job and I'm now working with more older children than I was previously, which means I'm being challenged to think of different ways to address skill development. This week I played a game of Twister with a couple of my students. What a fun way to work on strength, motor planning, and right/left identification! What activities do you use to work on right/left identification?

Wednesday, October 24, 2012

A Parent's Perspective - CP Daily Living

Today I am pleased to introduce to you, Michele and her family! Michele and her husband created a website, CP Daily Living, for parents and caregivers to access information and resources about cerebral palsy. After their daughter, "Maya", now age five, was diagnosed with cerebral palsy, they noticed a gap in online resources for parents and caregivers of children with cerebral palsy.

Part of their goal is to provide information and resources so that people won’t have to scour the Internet to find it the way they did. The other part is more personal: to share how they struggle with daily challenges and try to get ready for long-term ones. Michele says, "We offer this site as a place of hope, possibilities, and love. Whether it is through simply identifying with a mutual struggle, or learning a better way to do something, or finding a new resource, we hope to make other families’ paths more manageable and graceful with each passing day."

Read on to hear Michele's perspective and to learn more about "Maya", age five, who has spastic quadriplegia with dystonic posturing and epilepsy.

Our life in five words:

Love, dedication, grey hair, silver linings, fabulous food

Four qualities I look for in a therapist:

  • Experience. Everyone needs to start somewhere and occasionally the less experienced therapist brings a refreshing perspective to the table. However, the complicated tone and movement patterns my child has require someone who has collected information over time that can only be learned, seen, or understood through working directly with children with neuro-developmental challenges.
  • Willingness to form a partnership (as opposed to a dictatorship) with me and with my daughter. We want someone willing to listen to our ideas, concerns, and what other interventions we are using that are working as well.
  • Holistic thinker who looks at the whole child and the individual parts and how they are working or not working together. Our OT picked up on a visual integration/processing issue that once we had understood and corrected, made a huge difference in our daughter’s ability to relate to her surroundings.
  • Someone who is patient yet firm with my daughter. Please don’t coddle my daughter, but also remember she is still a kiddo, and her road is challenging. We want her to reach within herself to move forward without being beaten down in the process. *Our OT shared with me that she learned a very important lesson when she repeatedly ask my daughter to pay attention and follow-through with completing a task. After the third reminder my daughter looked up and said, “Give me a minute, I am thinking.”

Three resources I can’t live without:

  1. Kids Beyond Limits by Anat Baniel
  2. Fruiteze for constipation
  3. Our bedside video monitor

Two words (or more!) of advice for therapists working with children with cerebral palsy:

Take time to discover what motivates my child and honor that inspiration by incorporating it into your working relationship. The more my child is inspired to take ownership of what she does in therapy (rather than having exercises done to her) the more inspired she feels to initiate practicing and learning more on her own. 

A word of advice for the parents of a child newly diagnosed with cerebral palsy:

One of the most challenging aspects of coping with CP has been to learn to accept the unknown. Cerebral palsy’s presentation and outcomes vary from person to person. Although a diagnosis of CP adds an element of permanency to some of your child’s challenges (rather than the child outgrowing them), have hope and persevere with an open mind, knowing that your child still has the opportunity to improve her skills and perhaps even leave behind some of her challenges. One thing you can know for sure is that you can help your child meet his/her greatest possible potential (thank you Anat Baniel). Adopting and feeling comfortable with this perspective is a process that takes time. You cannot accept your child’s diagnosis by burying your feelings or skipping over the process of facing and accepting them. As a family, it’s been important for us to move through our feelings in our own personal time and manner (and hopefully without hurting our child or one another). Grieving is a necessary and healthy part of coping with this journey and each of us grieves in our own way and at different places along the path.

As my daughter has gotten older, a clearer picture has emerged about what kinds of long-term challenges she most likely will face. Having this information has allowed my mind to stop chasing answers and move toward acceptance because at least I now have some idea of what we are dealing with. Before that time, I felt like I was playing that game called “Smasher” where monster heads keep popping up and the player hits them with a hammer only to have more continuously reappear. It’s exhausting, challenging, and makes your head spin as you try to maintain some control over the game. Just like with CP, after you have been in the game for a while patterns begin to emerge that makes it easier to use your energy efficiently to strategize. 

We found that over time a pattern and rhythm of development was emerging that made it easier to navigate this territory and begin to bring some order to what felt like chaos. We were able to see what therapies were and were not helping, and how often we should include them in Maya’s schedule. The goal has been for her to have the greatest benefit without losing skills or becoming exhausted or overwhelmed from too much new information.

When you let go even a little bit of trying to outrun CP, you will find more joy within each day as you begin to see and embrace your child apart from his/her diagnosis. It can be hard to do this. There is often a constant urge to compare your child to other children in order to gauge how much your child is affected by his/her CP. This is completely normal and is a step towards acceptance of reality. Your child will have his/her own developmental path and there is no guidebook for your child’s unique development.

After Maya developed epilepsy, I realized that I needed to shift to approaching her from a place of acceptance and persistence rather than from a place of fear and force. I began to see my beautiful daughter and her smile and light, and I realized that some of my feelings about her condition were translating into me sending her messages that she was not ok. I was fighting on her behalf out of love, but also out of pain, guilt, and a lack of acceptance about her condition.  I don’t beat myself up about it because it is a common and perhaps expected coping mechanism for many parents. I am not sure how I would or could have found my way through it any other way.

Over time the intense feelings I had after the first few years when she was diagnosed have faded into the background. They move in and out, but they visit me less often and are more manageable the further we go on this journey. As Maya has gotten older we have learned to focus on what works for her rather than what doesn’t. She has developed some wonderful gifts despite the challenges she faces.

One dream for my child:

To find fulfillment and joy in her life within the limitations of her diagnosis (whatever they will be) while always being able to rely on hope to lead her forward.

What I do to rest and recharge:

I take a nap whenever I have an opportunity and I find relief by jogging. I was never a runner but one day about a year and half ago I was so overwhelmed and angry that I ran out of the house like Forest Gump. From then on I was hooked. Bubble baths with good smelling treats always makes me smile. I also enjoy writing and gardening. A piece of chocolate or something sweet doesn’t hurt once in a while either.

Michele, thank you so much for stopping by! You and your husband have created a fantastic resource for parents! Readers, be sure to stop by CP Daily Living at to find answers to all of your questions about cerebral palsy. You can also follow CP Daily Living on Facebook or on Twitter: @cpdailyliving.

Monday, October 22, 2012

Finding Balance

World Occupational Therapy Day is coming up on October 27th and the theme of this year's event is Exploring Balance. As I sit down to write this post for Linda's World OT Day blog carnival, I feel like finding balance in my life is something I need to work on, especially right now.

Recently, my life has been in a state of transition and things are now starting to settle down. In August I made a cross country move and a few weeks ago started a new job, which means new routines in a new school, in a new city. And anyone who blogs knows that it takes way more time than you ever thought it would (or is that just me?).

So how to balance blogging with being an effective occupational therapist, a loving wife, a good friend, eating well, exercising, AND making time for myself? Here are a few of the things that I do (or am working on doing) to create more balance in my life. I would love to hear how others find balance.

Get organized.

Without a good organizational system, I would be lost and completely out of balance. I use a mix of high tech and low tech organization devices. For me, I use lists on my phone because I always have my phone with me. I keep a running grocery list, list of meals for the week, to-do list (daily, weekly, someday), restaurants I want to try, places I want to check out, TED Talks I want to watch. You name it, I've got a list for it. For work, I use an old-fashioned paper planner. My husband and I use Google Calendar to keep track of each other. He can see when I have yoga class and book club meetings. I can see when he has an evening or early morning meeting.


This is one that I really need to work on. My goal is to set a time (maybe 8pm?) where technology is turned off. No more blogging, Facebook, email, Twitter, Instagram...I'm sure I will survive. In fact, I'll probably sleep better by winding down earlier. Along the lines of disconnecting, I also need to choose an amount of time I'm willing to spend on my blog each day and stick to it. I'm sure whatever great idea I have can wait for another day.

In order to help others, help yourself first.

I truly believe that these are words to live by. I'm a much happier person and more compassionate in all of my roles when I take care of myself. By taking care of myself, I am in a better state of mind to help others. For me this includes drawing a firm line between work and life (which can be challenging with a work-related blog - see above) and taking time to do things that I love, like running, reading a good book and going to yoga class.

Do what you love. Love what you do.

I think Steve Jobs said it best in his 2005 commencement speech at Stanford University:
"...for the past 33 years, I have looked in the mirror every morning and asked myself: 'If today were the last day of my life, would I want to do what I am about to do today?' And whenever the answer has been "No" for too many days in a row, I know I need to change something."
We all have days when we don't want to do what we are doing. That's life. But if you ask yourself this question and you keep hearing "No" as the answer, then it is time to change something. Your routine, your job, your attitude, your expectations of what can be accomplished in one day. Whatever needs to change, just take the plunge and do it.

Continually evaluate what is important.

This goes along the lines of the Steve Jobs quote above. It is important to me that I be a caring and compassionate occupational therapist. It is also important to me that I make time for friends and family. It is important to me that I be fully present during the time I spend with my husband. It is important that I have "me-time" to recharge. While I do love blogging, and I do believe that my blog provides valuable information, it is not the most important thing in the world. Nor is it my entire identity. It's just a very small part of who I am. The blog can wait. It will still be there tomorrow, and the next day. The great idea I want to share can wait. All of the other blogs that I want to read and comment on can also wait, for they are not going anywhere either. Sometimes I just need to remind myself of that in order to maintain balance in my life.

So, there it is. A few things that I try to do to maintain balance in my life. It's always a work in progress and some days or weeks are more imbalanced than others. What? You said progress reports are due next week? I have how many re-evals due? That IEP is rescheduled for tomorrow? Aghhhh!!!! You get what I'm saying :) With that, I'll leave you with this quote from Alexandra Stoddard:

"Slow down, calm down, don't worry, don't hurry, trust the process."

OT bloggers, how do you balance blogging, work, leisure, family and everything else in life?Please share your secrets!

Halloween is right around the corner!

With Halloween coming up, now is a good time to review AOTA's Tip Sheet for Enjoying Halloween with Sensory Challenges. You can also read my Halloween tips here and tips from Sensory Smart Parents by clicking here. Lisa Quinones-Fontanez also shared some great tips on To The Max on Making Halloween Fun For Kids With Autism.

Yahoo Voices has some recommendations for Halloween costumes for sensitive kiddos, using mostly clothing that your child already wears to create a costume. That may make it easier for your child to accept wearing the costume.

Some tasty treats for Halloween:

Simple Pumpkin Cookies from Stephanie at Early Intervention Speech Therapy
And here are a couple of my favorites from last year:
Sweet and Salty Pumpkin Seeds
Dirt and Worms (this recipe helps develop fine motor skills, too!)

Halloween crafts:

Handprint Spider from Housing a Forest
Fall leaf fine motor craft 
4 Halloween Fine Motor Activities from MamaOT
Fine motor pumpkin from Embrace Your Chaos
Clothespin Spiders

Get messy:

Pumpkin spice playdough

Visit Growing a Jeweled Rose to learn how to make pumpkin scented paint or pumpkin scented cloud dough.
If your little ones aren't quite ready to get messy, Miss Mancy has a great Touch, Feel, and Sort Halloween activity, which also works on fine motor skills. Gotta love that!

Get up and move:

Ghost bowling from No Time for Flashcards (works on fine motor skills, too!)
Miss Mancy has a fun spider maze to work on lots of OT skills.
Take those pumpkins outside and do some chuckin' pumpkin painting. I love this idea from Childhood Beckons!


Sensory Smart Parent recommends reading the book, Go Away Big Green Monster, with your child prior to Halloween, to address fears and how to manage them.

Pam Dahm, of Chit Chat and Small Talk, shared a Trick or Treating Social Story. Social stories are another great way to help prepare your child for Halloween.

What are you doing to prepare your child for Halloween?

Friday, October 19, 2012

Five Friday Features

And the Easy Tie Shoelace winners are...Lisa and "just me". Please email me with your mailing address and I will get your shoelaces in the mail!

  1. Did you know that October is Sensory Awareness Month? Visit Simply Stavish to read my guest post: What Every Parent Should Know About Sensory Processing Disorder. Be sure to poke around Mindi's blog while you are there. She has tons of great content about speech and language!
  2. Handwriting Without Tears is offering a free online seminar on Tuesday, October 30 from 8-9PM EST. The seminar, Top 10 Questions About Handwriting, is sure to be full of useful information about handwriting education. I've watched Handwriting Without Tears seminars in the past and I'm always impressed with the organization and content. In my opinion, they are especially useful for new practitioners, parents and teachers.
  3. Do you use tongs and chopsticks all of the time to work on fine motor skills? MamaOT had a great tutorial on how to make kiddie chopsticks. Check it out! These chopsticks are easier to use than traditional chopsticks and are a great way to develop fine motor skills. (And she had a great follow up for 50 fun ways to play with tongs)
  4. OT research in the news!!! Occupational therapy researchers from NYU found that classroom yoga helps improve behavior of kids with autism.
  5. Didn't win the shoelaces? Don't despair! I have another giveaway. This one is from Educational Insights. Educational Insights manufactures educational toys and hands-on learning materials. And they've been kind enough to sponsor a $50 giveaway! Click here to find out what you have to do to enter. (Hint: it's really easy!)

Thursday, October 18, 2012

October is Sensory Awareness Month

Do you want to learn more about sensory processing? Well, you're in luck! Today I am over at Simply Stavish sharing what sensory processing is and how problems with sensory processing might present in children. Head on over to read all about it!

Never visited Simply Stavish before? Simply Stavish is written by Mindi, a pediatric speech-language pathologist and mom to two young boys. She shares her thoughts on parenting, photos of her family life, and ways to turn everyday moments into language learning opportunities. While you're there, be sure to check out her super-useful language development stages for birth to age 5 and Eating 101: Picky Eater vs Feeding Disorder. I promise you will not be disappointed with anything you read over on Simply Stavish!

Wednesday, October 17, 2012

A Parent's Perspective - Outrageous Fortune

Today I'd like to give a very warm welcome to Shasta Kearns Moore, mom to adorable two-year old twin boys, JJ and Malachi. Malachi has quadriplegic extrapyramidal cerebral palsy and dysphagia (a swallowing disorder related to his cerebral palsy). Shasta blogs about Malachi's journey at Outrageous Fortune. I have been following Shasta's journey thought her Dark & Light Kickstarter campaign, which has resulted in a published a children's book, Dark & Light: A Love Story in Black and White, to raise funds for her son's therapy. I am so happy to have Shasta here today to share her perspective!

Our life in five words: 

Busy, thoughtful, roller coaster, books, love


Four qualities I look for in a therapist: 

  1. Maturity: I very much don't mean that in the sense of age. I mean that in the sense of complexity of thought and a calm demeanor. I believe people can interact with children without resorting to "coochie, coochie, coo!" or flashy lights and loud music. I also want them to understand in a really deep way what it is they are doing and why.
  2. Communication: Perhaps it's because I'm a writer, but communication is huge to me. I need a therapist who is willing, open and able to talking about what they are doing and why. Since it's me and not them who is interacting with my son on a daily basis, I need them to be able to explain to me what's going on so that I can implement their strategies and give my son the maximum benefit of their expertise. In fact, I think some therapists could do well if they interpreted their job as more of a parent teacher than a child teacher. Have the parent get hands-on and do the exercise every once in a while while you are there to guide them. 
  3. Professionalism: I need a therapist who gets down to work, even if that work is play! A therapist's job is to help and think creatively and offer solutions to problems, not to chit-chat. 
  4. A teaching paradigm: My son has cerebral palsy, which is a brain disorder although it is often treated like a muscle disorder. I need the people who work with him to see that he has limitless potential, just like any little boy, because he is capable of learning. He does not need to be "fixed" nor can he get better at something simply by "working harder." Compare this to a child who is struggling with algebra. We wouldn't consider him irreparably broken because of his initially poor math skills and we wouldn't think the solution is to force him to "work harder" at repetitious assignments. We would think creatively and try to supply him with the missing information he needs to understand and then allow him to reach the logical conclusions for himself. This is not only a much more effortless but a much more successful approach. It's not that Malachi's muscles aren't under his control, it's that he doesn't understand how to use that control. Teach him and, step-by-step, he will learn.

Three resources I can’t live without:

  • Baby Einstein music toy. This thing is fabulous. Both boys love it, but Malachi would crawl to the ends of the earth for it. The music is nice and soft (there are two volume levels) and never gets annoying. The button is very large and easy to push. The handle makes it nice to carry. The lights are entertaining for when you need a break!
  • Alphabet mat. I really think Malachi would not be crawling as well as he is right now without this. This mat is hard enough to give him feedback about where he is in space but soft enough that he's not grinding his elbows off or going to chip a tooth if he slams his head into the ground. I think it makes him much more willing to try new things and make mistakes since he doesn't have to pay so dearly for them as on our wood floors.
  • Kids Beyond Limits by Anat Baniel. This book irrevocably transformed the way I see my son's disability and gave me real, concrete tools I could use to improve not only his life, but my own. It talks about how the brain learns, and once you start talking about the human brain, you realize how the same theories can be applied to pretty much any aspect of human life. I cannot urge you strongly enough to get a copy.

Two words (or more!) of advice for therapists working with children with cerebral palsy:

 As I said before, I think a major shift needs to take place towards viewing CP as a brain disorder instead of a muscle disorder. This is a really huge and complex issue, but I highly recommend reading Kids Beyond Limits to really understand how different the approach to CP can be. I've found this approach helps me relate so much better with my son's struggles. Instead of thinking that there is some sort of invisible and incomprehensible resistance in his muscles, I now know that the actions I see are simply a byproduct of disorganization in the brain. It's like if I held a glass of water with one hand and checked the watch on the wrist of my other and accidentally poured the water out. At that moment, my brain was just disorganized — confused as to which hand it needed to rotate. That's what the majority of CP symptoms are like — movements that aren't sequenced correctly or are grouped ineffectively together in the person's mind. So the task is teaching the brain the difference between different parts of the body and the sequence needed for using them effectively, not stretching, cutting, botox-ing or otherwise treating the muscles as separate from the person inside who is wielding them.  

A word of advice for the parents of a child newly diagnosed with cerebral palsy:

Well, I'll get off my Kids Beyond Limits/ Anat Baniel Method soapbox for a moment and just talk about the effects of the diagnosis on a parent's psyche. For this, I would recommend finding or creating a community of parents going through the same thing. For me, I started a blog and met lots of parents — even parents of multiples with CP — who made me feel not quite so alone in my struggles. The difference between how I felt before I had any real idea of what living with CP would be like and today is like night and day. All fear comes from not understanding the future. The more you can learn about what it's *really* like to have a kid with CP, the more you see that it's not so scary. 

One dream for my child:

That he will walk independently. I've told myself that I will be happy if he can just crawl and sit up independently. I will consider us to have crossed the finish line. But if I'm really honest with myself, I do dream he will go further than that, even though, in fact, especially because conventional wisdom says he won't.
Actually, more than anything, I hope that he is accepted for who he is by his peers. Yes, more than walking, or even crawling, I hope that he can make friends and keep them.

What I do to rest and recharge:

Read fiction, sleep, watch Netflix with my husband, and blog. (Yes, blogging is often a stress release!)


Thank you so much for stopping by, Shasta! Your words are truly inspirational! Readers, you can follow Malachi's progress on Shasta's blog, Outrageous Fortune.
Other ways to keep up with Shasta and Malachi:
Twitter @ShastaKM, Facebook, and Pinterest
And of course, don't forget to check out Shasta's new book, Dark & Light: A Love Story in Black and White.

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