Info Spot 4 the Special Tot

disAbility Sports Training and Athletic Competition

2012-01-14T21:09:00.000-08:00

It's always nice to stay active in sports, but for parents of children with disabilities it's not as easy as signing up just anywhere! The following link provides a long list of various links for adapted sports:

disAbility Sports Training and Athletic Competition

Play ball!

Therapists Consulting with School & Daycare Staff

2011-11-30T19:46:00.000-08:00

It seems this year has been extra crazy and busy, which means I haven't blogged near as much as I did the previous two years...oh well, if life even slows down a bit, then I'll get back to blogging more. Ironically, I don't watch television very often or do other things that you would think should take me away from my blogging, yet somehow the days and evenings fly by!

In addition to me working part-time for an early intervention program in which I work in homes, daycares, and in the community with children ages birth to three years with special needs, I also work part-time for myself. I see a few children on a weekly basis as well as conducting consultations and evaluations for a local school district (not the one I work for ECI or the one my daughter attends). So, this year I have learned a lot about billing insurance companies, facilities, and Medicaid...lots of lessons have been learned! But the biggest thing that I've enjoyed doing this year (besides being a Mom of two children and a wife) is providing consultative services.

Consultations are really important and that is why most school occupational therapists spend most of their time doing that versus direct services. Because the therapist is only around a child a small part of the week (or for some kids even less), and the parents, teachers, or daycare staff are around them for the majority of the time, then doesn't it make sense to teach them a few simple strategies that can make a difference in that child's life. Some of the suggestions can be as simple as putting the child at a table that faces a less "busy" area and therefore is less distracting so the child can remain seated and do his "work". Ideas may also be as simple as rewording requests, keeping instructions short and simple, using a picture schedule system, or making sure the table/chair is at the appropriate height which provides better support for handwriting and focusing.

Consultative services doesn't mean that the child doesn't also need direct therapy, it just means that there may be adaptations to the environment that could make a functional difference. It might also mean that teaching the adults to interact differently with the child could make a difference. For example, for a child who transitions poorly between activities at a daycare one suggestion may be to give him a one minute verbal update of what will be coming next. Predictability often lessens anxiety in children with developmental disabilities, especially the children with sensory processing disorder (SPD) and autism spectrum disorder (ASD).

I've learned through the years to not get all of my "therapy kicks" out of directly interacting or touching the child. When I was first out of college, I wouldn't have dreamed that I could help out a five month old with Down Syndrom so much unless I was literally touching the child helping him to roll over or helping with some other motor or feeding skill. Yet, now I know that if I show the parents a few strategies for "tummy time", positioning while holding/feeding the baby, and diapering that I'm making a big, maybe even bigger difference than I am by directly working with the child. It has been a change for me not to be the one to feed the client, but to be the one guiding the parent either verbally or physically. After all, it's not "all about me"!

So, if your child gets direct services only at a clinic, then ask the therapist if she/he is willing to do a home visit at least once. Insurance may or may not pay for it, so funding could be an issue. If you can't afford to pay for the home therapy visit privately, then videotape the surroundings of your home during the daily routines that are difficult such as toothbrushing or meal times; have the therapist view it and give any suggestions on how to help that routine go smoother. Maybe the therapist will also be fine with you participating in the therapy session at the clinic so you can learn some activities to do with your child in between sessions. At the very least, get a handout individualized to your child on activities or adaptations that would be beneficial.

Making Halloween Fun For All

2011-10-24T18:42:00.000-07:00

It's Halloween time! Many of us think it is fun, whereas others are not feeling the same amount of joy as the rest of us! In hopes of making the holiday more pleasant for all, I have provided a link on ideas for adapting this holiday for a child with Autism Spectrum Disorder. I also think these ideas could work well with any disability or young child:

http://www.autismsupport.org/halloween.html

My small family of four likes to dress as a theme. Last year we all dressed up as characters of Toy Story. This year we will be characters from Peter Pan...even the dog is dressing up as a pirate. Since my three year old son gets scared of "spooky" things easily, we probably will be wearing "happy" costumes for a while. Last year, he became very upset with the decorations we had on our front porch, and would only go out the back door until the decorations were taken down the day after Halloween. So, if you have a case like this, some of the ideas in the link may work well for you even with a child who doesn't have a developmental delay or diagnosis of autism.

Enjoy trick-or-treating and HAPPY HALLOWEEN!

Social Stories to Improve Behaviors

2011-09-18T20:13:00.000-07:00

I am a big fan of social stories to teach young children and/or children with special needs (any age) when there is a problem with a behavior or the child is anxious about a situation. The concept originated by Carol Gray. Although social stories are often used with children with an autism spectrum disorder, I have found that you can use them with many children with developmental delays or young children with no delays. Here is a link on how to make one:

http://www.ehow.com/how_5135970_use-social-stories.html

This link probably gives ideas for grade school children, and adapting it for the toddlers would mean doing more of the work. I have had my own children help me by coloring some of the pictures in the book.

I have made quite a few for my own children, and they like to read them even after the issue has been solved. Back when my daughter (now 7 years old) was three years old, she was very scared to go to swim lessons. So, through reading the story to her daily she became less anxious. That is because the predictability of the lessons lessened her anxiety. So often, children act up when they do not know what to expect, and through writing an individualized story about what may happen and what is expected of them, their anxiety may lessen.

Some of the stories that I have taught families to write for their child have included: going to the dentist, airplane rides, gymnastics class, swimming lessons, birthday parties, Christmas day, potty training, the choir singing at church, and the list goes on. Remember, when writing a social story to stay as positive as possible and emphasize the behavior you want from the child and don't say a bunch of "no" and "don't". For example, if the child has a problem with running in the hallways at school you may say in the book "we walk in the hallway quietly and slowly while listening to the teacher" as opposed to "we don't run in the hallway and disobey the teacher".

I would love to hear stories about some of your favorite social stories that you have helped write!

Is your child ready for preschool?

2011-08-17T20:58:00.000-07:00

Since most children are going back to school over the next couple of weeks, I thought I'd post a link on preschool readiness. Preschool is important for many children, especially those with learning disorders or developmental disabilities. If they go to preschool, then they may perform better in kindergarten. ..they may even have fun in kindergarten!

First 5 | California

I have a friend who used to be a kindergarten teacher. She once told me that the best thing a parent can do for any child to prepare them for kindergarten is to send them to preschool or another part-time program such as Mother's Day Out or daycare the year or two before starting kindergarten. It is hard to learn in kindergarten if the first part of the school year is full of separation anxiety... get that out of the way in preschool!

Halliwick Method to Teach Swimming

2011-07-07T08:47:00.000-07:00

It's that time of year when most everyone wants to cool off in a pool, especially if you live in the southern USA like I do...too many days where it is 100 degrees F or above! For many of us, we want our kids to feel comfortable around the water, have safety awareness, and also learn how to swim. Some kids are harder to teach swimming to than others, and especially if the child has a medical or mental disability. Here is a link about the Halliwick method that can be used to teach swimming, it was created by a physical therapist who is an aquatic specialist. He has techniques for a variety of special needs including pediatric and orthopedic disabilities.

Halliwick

So go ahead, gather up your intertube, rubber duckies, and towel and head off to the swimming pool!

ZERO TO THREE: Self-Control 24 - 36 Months

2011-06-19T21:45:00.000-07:00

Although my son turned 3 years old earlier this month, I do not expect him to never have tantrums or meltdowns. Yet, I already noticed over the past couple of months that they occur WAY less. Here is a link on the behavior and self-control of a two year old and some strategies to use:.

ZERO TO THREE: Self-Control 24 - 36 Months

Toddlers are SO much fun, but they are also unpredictable! So, it's always nice to have a better understanding of why they behave the way they do.

Simply Thick Lawsuit: Free Consultation with Attorney necrotizing enterocolitis NEC

2011-05-26T18:54:00.000-07:00

Please spread the word about this important information regarding a recall on Simply Thick and a possible link to NEC:

Simply Thick Lawsuit: Free Consultation with Attorney necrotizing enterocolitis NEC

Animal Assisted Therapy for Special Needs Children

2011-04-25T11:53:00.000-07:00

In honor of my family getting a puppy 2 weeks ago, I thought I'd post this link on how animals can help children with special needs:

Animal Assisted Therapy for Special Needs Children

When I worked at a rehab hospital for adults with neurological injuries I really enjoyed seeing the trained dogs come in and mingle with the patients. So many of the adults were so happy to see the dogs, and it was amazing how some of them tried to move an injured arm or speak more around the pet! I've also seen this same effect with children with special needs. Even children with only developmental delays do well with dogs. A few years ago I was working with a 16 month old boy who wasn't walking; he had mild sensory modulation problems, but other than that just a delay with walking and talking. His mother adopted a 2 year old dog, and guess what, the boy began walking and talking within 3 weeks of the family getting the dog. These two were best buddies, and it was so amazing to see how this gentle dog helped this boy. The little boy was motivated to walk so he could keep up with his best friend! I have many stories about how dogs, cats, and horses have helped the children I work with. I would love to hear your stories too!

ZERO TO THREE: Sleep Challenges in Infants and Toddlers: Why It Happens, What to Do

2011-04-06T08:09:00.000-07:00

Whether it be from my friends or parents of children I work with, I get asked a lot of questions about how to help babies and young children sleep better. Here are some good ideas on the challenges of sleep:

ZERO TO THREE: Sleep Challenges in Infants and Toddlers: Why It Happens, What to Do

I've been lucky that my son slept through the night (7 hours or more) by 6 weeks of age and my daughter slept through the night by 8 weeks of age. Unless they were sick or teething, they have been excellent sleepers. Of course, there has been the occasional night mare or delay tactics in going up to bed, but overall I've been lucky in the area of "sleep". My husband and I put the children down at the predictable time of 7:30 for my son (he'll be 3 years old in June) and 8:00 on school nights for my 7 year old daughter. They have the potential to get 11 hours of sleep at night on a weekday, and then my son may or may not also take a nap at preschool or home (depends on if it is a day I work). For that age group children need 10-14 hours of sleep in a 24 hour period, and my children get that. So often, a child's behavior problems or school difficulties can be lessened by making sure they have a proper amount of sleep...notice I didn't say the problems vanish, just maybe lessen depending upon the child.

Feel free to post sleep problems and solutions that you have had with your child or a child you work with!

Increasing the Intensity of Sensory Input

2011-03-23T12:16:00.001-07:00

A sensory diet is when additional sensory input is added into the child's daily activities. This might include making sure the child runs around or swings at recess as opposed to them just sitting there on a bench. It might also include a child wearing a weighted vest or backpack while on an outing. The list is never ending of how sensory input can be weaved into a child's daily routines: marching between locations, vibrating pen, "heavy work" activities such as cleaning the chalkboard or carrying groceries for parents, or even extra trips to the neighborhood park.

So what is a parent to do when they have tried a sensory diet and the child still needs more? Well, that is when the occupational therapist (or other clinician trained in sensory integration techniques) analyzes the input the child is receiving. They should be asking about intensity, duration, frequency, and mode of sensation.

Intensity levels can be altered with jumping by adding a mini-trampoline versus just jumping on the ground. This can be made even more intense by the child jumping on a large outdoor trampoline. Another way intensity could be increased is to buy special suspended equipment such as swings with bungee cords that allow extra resistance as the child swings. These can be found at:

www.southpawenterprises.com

Some of the families I work with already have the outdoor play gyms that have a swing, slide, ladder, and "rock" wall. Often, suspended equipment could be used with these play gym systems. So a regular sling seat swing could be replaced with the "frog" swing which is also a sling seat, but has bungee rope at the top so the child is bouncing up-down in addition to being able to swing front-to-back.

Intensity could be added to marching by adding 1-2 pound leg weights around the child's ankles as he marches. Other ideas include: Joint compressions, a game of tug-of-war, deep massage vs. light touch, songs with words versus just instrments...and the list is never-ending!

Duration: length of time of sensory input. So, if the family tends to let the child play at the park for 20 minutes, maybe the time should be lengthened to 30 minutes or more. This is especially the case for a child who has sensory modulation disorder with the symptoms of sensory seeking or sensory under-responsiveness.

Frequency: means the amount of times during the day. If the child only gets one "wiggle" break at school/home then maybe the child needs more "wiggle" breaks. The average adult attention span is only 45 minutes of listening, and for children it is even less. So, we know that many special needs children can't focus as long as a typically developing child...so, more "wiggle" breaks are needed! If breaks are not possible, then fidgets for the hands or a cushion for the bottom such as the Movin' Sit (R) could be helpful.

Mode of sensation: is the input tactile? auditory? visual? movement (vestibular and/or proprioceptive)? smell/taste? oral-motor? Changing up a sensory diet with various types of input may be necessary. This can be frustrating to teachers and parents because after a few months of the ideas given by the therapist they aren't getting as good of results. Altering the sensory diet can be a guessing game especially when the child fluctuates from day-to-day or even hour-to-hour!
Maybe if the child tends to like motion that is up-down such as bouncing on a ball or jumping on a trampoline, then a different kind of movement could be added to the sensory diet. Examples of more intense motion include rotary/spinning or upside down movement. Examples of less intense motion include front-to-back or side-to-side motion at a predictable pace.

I hope this article got you thinking! Once a sensory diet is in place, it probably will have to be tweaked here and there...especially if there are lots of changes in that child's life.

Indwelling Thumbs in Children with Spasticity

2011-03-12T21:06:00.000-08:00

It has been a BUSY month so far, so this is my first post of the month... the longest I've ever went without writing an entry! Oh well, Happy Spring (almost)!

Lately, I've been working with quite a few children of all ages who have spastic quadriplegia; this is when both legs and arms have extreme tightness due to neurological impairments, and typically the upper body is less functional than the lower body for these children. For the younger children such as infants and toddlers, I often suggest "Joe Cool" or "Benik" splints (sometimes with a harder material inserted between the thumb and index finger) in order to help the thumb not stay tucked in the hand. Some children require night-time splints (e.g. from orthoplast) as well, but I am simultaneously encouraging as much active movement as possible. But unfortunately, active movement isn't always possible; this is especially the case for a child who has suffered a near drowning, CMV, PLV, or a TBI. In that case if a splint isn't tolerated due to too much tightness and orthopedic mal-alignment of the fingers (wrists, IPs and MCPs), then I suggest rolling up a small washcloth within their hand. This gives the web-space a small amount of support without an excessive, painful stretch. If the thumb and fingers continue to be tight over numerous years, then the creases within the palm can become "stuck" to each other which makes it pretty much impossible to open the hand to full passive range of motion, and if it does occur the skin may rip and/or bleed. Even for the kids who may never actively move their hands due to severe physical and cognitive involvement, getting the thumb to not tuck is important... dislocated bones or "windswept" deformities can be painful!

Of course, I always promote massage, stretch, weight-bearing through an open hand, and active use of the muscles when possible. Also, some children need a customized splint created from an orthotist or occupational therapist. Some "ready made" dynamic splints may even work. In these cases, I have to investigate funding ideas if insurance doesn't reimburse for it and if the family doesn't have the financial means to pay for it.

I would love to hear other strategies for helping reduce indwelling thumbs in children with neurological damage. If you have any, send them my way!

ZERO TO THREE: Steps Toward Crawling

2011-02-20T21:31:00.000-08:00

Here is a great article on what happens right before a child typically learns how to crawl and the various styles of crawlers:

ZERO TO THREE: Steps Toward Crawling

The only thing I would add to this article is some other types of atypical crawling:
-segmented: the child crawls but it appears slow, and not fluid as if every movement of the arms or legs have to be thought out. This can be a sign of a variety of problems including neurological
-bunny hop: the child crawls with the hands and then hops forward with both feet simultaneously coming up under him, just like a rabbit does. This can be a sign of neurological, muscular, or orthopedic problems
-bear crawls and can't bend knees- this is when the knees are extended vs. bent, it can be nothing to worry about unless that is all the child can do. It could be due to muscular tightness, orthopedic, or neurological problems

These atypical patterns in addition to the ones listed in the article (e.g. using one side only) may resolve after the child has been crawling for a couple of months. If they do not, this should be discussed with the child's pediatrician to consider a referral for therapy and/or a specialist (neuro or ortho)..

It is important that children crawl, but not mandatory. I have a 16 year old niece who skipped crawling and began walking at 8 months. She climbed furniture by 10 months, and went on to be a high level competitive gymnast. She takes advanced classes at high school. So, although she has no gross motor or learning problems, skipping crawling can be an indicator for that...not always, but can be sometimes. Crawling helps the brain learn to use the two sides of the brain together, develop arches within the hand muscles for fine motor control, and promote depth perception (eyes). Maybe this is why my niece's handwriting isn't exactly the best...not awful, but not great either!

Study of Early Child Care and Youth Development (SECCYD)

2011-02-13T11:05:00.000-08:00

A common suggestion that I make for toddlers with a developmental delay, particularly with language skills, is to go to daycare, preschool, or Mother's Day Out (MDO) for at least 2 days a week. I make this suggestion especially for children who don't have siblings or who are the oldest child. Children need to be around other children their age which helps them learn how to play, talk, and share. Having said that, there is a difference between how kids thrive in good child care and low quality child care. Here is a link to an interesting study that evaluated how children progressed with development in different types of daycare:

Study of Early Child Care and Youth Development (SECCYD)

I realize that not everyone wants to send their child to a facility such as MDO or daycare, or maybe they want to but can't afford it. In that case, I help the parents brainstorm other ways to be around children, such as play groups, library story time/ craft time (FREE!!!), church activities, neighborhood groups, and other public places that may have free admission at least once per week such as an interactive children's museum. My subdivision has a monthly newsletter and within it, dates/times are identified for Mom's groups, play groups, and special events. It may not be the same teacher and peers each time like a daycare or preschool would be, but at least there is socialization among the children.

Autism Speaks, Community, Family Services,

2011-02-07T17:59:00.000-08:00

I came across an amazing website "Autism Speaks" recently. I was so impressed with how they had very detailed videos displaying what a typically developing child would look like for a particular play or language skill, and how a child with autism may look like doing the same task. Also on this site was a huge data base of different types of treatment in the various cities in each state. What a great source for a parent of a newly diagnosed child or for a family that will be moving to a new town! Here is the link with the names and numbers to some facilities in Texas:

Autism Speaks, Community, Family Services, Texas: Categories

Even though this link is for Texas, the other states are represented also. Some of the links include: ABA, early intervnetion (birth to three years), preschools, OT/PT/Speech therapy, biomedical interventions, doctors, and community support. I will definately be sharing information from this site with the families that I work with!

iPod | iPhone | iPad Apps for Special Needs Children

2011-01-22T19:40:00.000-08:00

I was just fiddling around with my iPhone and downloading some applications today. My search was on a variety of pediatric diagnoses seen in OT, PT, and speech, and not too many came up, which surprises me. But once I read how much has to go into creating an app I figured out why there aren't many! There are over 200,000 apps. available so maybe I just couldn't find the right ones. I have MANY ideas on some possible apps, and maybe one day I will actually get around to creating one...too bad I am not good friends or relatives with a computer programmer! One app that I came across that I did like was one specifically for children with autism:

iPod | iPhone | iPad Apps for Autism

Another one was for identifying a baby's various cries. So many of the parents have problems with deciphering the cries, which means the baby may get over-fed, put down for sleep too often, or over-stimulated. This app looked like it could be beneficial to new parents: http://www.crytranslator.com/

I would love to hear of some of the other good apps out there. Please, send info. on them!

Helping Children Play Within an Organized Space

2011-01-16T18:24:00.000-08:00

My daughter and I went through all of her toys yesterday to make room for all of the toys she got for Christmas last month. I had her make various piles: one for toys to keep, one for missing pieces, another for toys to donate, and of course the trash can! Within the donate pile, I started to think of who I could give each item to such as a particular child on my caseload, her younger 2 year old brother, a daycare, or the Goodwill.

I go through the kids' rooms at least twice a year and it helps our whole home to not be taken over by toys! I plan to do my son's room tomorrow...but without his help! He is like the average two year old who doesn't want to part with toys even when they are broken. This is why he has a couple of injured Barbie dolls that were previously his sister's, you know, the one's that have a missing foot or received a "haircut" that wasn't so attractive!

This event got me to thinking that as an occupational therapist working in the homes of families with special needs children I am able to help families go through their toys and organize them. I can help find the toys that are appropriate for the child (and siblings) to play with as well as box up toys that are too young for them developmentally. So often the children I work with that have developmental delays get over-whelmed by too many toys in a space; so I find that removing toys not used anymore really helps them focus better on the toys that are still left. Something so simple can help a child to have a longer attention span or even less sensory defensiveness. For kids with poor motor planning, it helps them to make better choices of what to play with as opposed to choosing a "baby" toy. For example, if all of the rattles are put away, then maybe the child will reach for blocks, books, or dolls.

For children with delayed language, make sure you leave some musical toys and other items that promote language such as a tape player they can carry around, "microphone", megaphone, whistles, and books.

For children who are sensory seeking/ hyper-active, you may need to make sure you have some action toys in the room such as a mini-trampoline, tunnel, or balls.

For children with poor motor planning, low muscle tone, and/or sensory under-responsiveness (low registration), make sure you have toys setting out visibly and not all of them stored away in closed containers high up on a shelf. These children will most likely not seek those toys out when asked to "go play in your room". I recommend a few toys put in a couple of baskets within their reach. Too many toys in one basket can be over-whelming, so don't over do it! Also, have toys that they would be successful with and some that are for the next developmental milestone. Cars, balls, and dolls are simple toys, whereas a kitchen with plastic food, a race track, and Mr. Potato Head are more challenging. If all of the toys are too difficult for them then the child will just get frustrated and depending upon the diagnosis may choose to sel-stim.

A child with abnormal muscle tone who tends to slump or w-sit could benefit from a kiddy table and chair to offer support and an alternative to just playing on the floor; make sure the table and chairs are at the proper height. If the chair is too low then the child will lean and hunch over the table. If the chair is too high, then the child's feet will dangle which offers less stability for the posture muscles. If the chair is a good height but the table is too high, then the child will have his elbows too high for good fine-motor skills including legible handwriting for homework (older kids) or scribbling (younger kids). Some children will give up when a task is too hard and may even walk away whereas others will start to "act up".

Of course, one of the most important things is teaching the child to clean up. If he/she is not physically or mentally capable of cleaning the entire space, then think of at least one thing they could do. For some kids it may even be that you have to offer hand-over-hand assist through each step. For children with a poor ability to transition, then this is a nice transition helper, especially if it is done in a predictable way. Predictability could include singing the "Clean Up" song each time, or it could include watching a video for 10 minutes after the room is cleaned. There isn't a magic routine, yet structure and predictability help so many children (with or without special needs!).

The list goes on and on about all of the ways you could organize toys and alter a play space. Hopefully, the ones I've listed get you to thinking of how you could help your own child or a client!

CTV Toronto - Sibling spacing may be tied to autism risk: study - CTV News

2011-01-13T09:17:00.000-08:00

An interesting study about siblings age and the incidence of autism:

CTV Toronto - Sibling spacing may be tied to autism risk: study - CTV News

I hope they keep finding more clues to the causes ( or possibilities) so they can work on prevention and cures for autism!

TheraSuit- Suit Therapy for Kids with Cerebral Palsy

2011-01-05T11:42:00.000-08:00

I worked recently with a child (diagnosed with cerebral palsy) who made many gains with the Suit Therapy using the TheraSuit. Here is a link:

Therapists Use New Methods For Children with Cerebral Palsy | OT Pediatrics News

I've had many kids over the years try alternative therapies, and some of them with good results. The kids have traveled to other facilities for weeks to months receiving various therapies in hopes of getting better motion, balance, and functional skills. All of the ones that have made significant improvements have been the ones who recieved intensive therapy of multiple hours a day: Suit Therapy, Constraint Induced Therapy, hyperbarric oxygen, and many other therapies that aimed at integrating reflexes and providing lots of proprioceptive input. This makes me wonder if NDT and some of the other popular therapies used by most therapists would get similar results if we provided multiple hours of therapy a day....food for thought!

Kindermusik Home | Toddler Preschooler Infant Children Music Classes

2010-12-20T07:30:00.000-08:00

I'm a big fan of Kindermusik! I am lucky enough to live in a bigger city where there are multiple locations that classes are conducted. Their classes are so fun, and some include learning sign language!

Kindermusik Home | Toddler Preschooler Infant Children Music Classes

I have had many OT (occupational therapy) clients who weren't learning to talk with just speech therapy or developmental services, but did learn to speak after attending Kindermusik classes! Now, it is not designed just for the special needs child yet these children potentially can benefit greatly. One child I am thinking of who benefited is a child with ASD (Autism Spectrum Disorder), and at age 2 1/2 he was still mostly non-verbal except for saying "mama, dada, and hi". After attending a few Kindermusik classes he began humming, then with a few more classes he began to insert a few simple words into the song mixed in with the humming. At that time, he still was unable to express his needs and wants, but at least he was speaking! Then, during speech therapy sessions the therapist began to encorporate his favorite Kindermusik songs and instruments with more traditional therapy techniques. Within six months the child had a vocabulary of between 75-100 words, and was able to express some basic needs and wants...yeah! Once he turned three years old, he graduated the program (early intervention) that I work for so for a while I didn't know how he was progressing. Then, about a year later I saw him at a birthday party that my daughter was attending. I could not believe the difference in his language skills! He was not only expressing basic needs/wants and labeling items, but he was socializing with other children as long as it wasn't too loud in the room. Unfortunately, his sensory processing skills hindered his ability to stay in the room for some of the games and as the "Happy Birthday" song was being sang, but Wow had he made progress! I don't think Kindermusik cured all of this child's speech/communication problems, but it did jump start his ability to talk.

Tummy Time for Baby | Articles | Babies Today

2010-12-12T18:51:00.000-08:00

Tummy Time for Baby | Articles | Babies Today

Gifts for Kids With Special Needs

2010-12-12T18:28:00.000-08:00

It's that time of year already! Whether you celebrate Christmas, Hanukkah, or any other holiday filled with gift giving, it is time to think about what to give your loved ones. This can be difficult when thinking of what to get a friend or relative with special needs. Here is a link filled with considerations for gift giving to children with Autism:

Gifts for Kids With Autism | eHow.com

Many of the parents of the kids I work with like to identify adapted toys in therapy catalogs as potential gifts. The families then provide their friends and relatives with links to the therapy companies' websites. This is especially a good idea when the child has physical disabilities that limit the way he can manipulate commercial toys found in local retail stores. Here are a few companies to consider purchasing special needs toys from:

For infants, toddlers, and preschool age children: http://www.beyondplay.com/index.htm

For children of all ages: http://www.southpawenterprises.com/

and http://www.pfot.com/ and http://www.therapro.com/

Mother-Infant Interaction: Achieving Synchrony : Nursing Research

2010-12-03T19:11:00.000-08:00

I went to a conference today. I always love to learn new things, and then share the info. and resources with others. Found out today about this study on mother-infant interaction, and thouht I'd share:

Mother-Infant Interaction: Achieving Synchrony : Nursing Research

The smallest of interactions can make a difference. It might be as simple as picking up a baby when he's crying or it might be talking in a soothing voice to them as you give eye contact. But what ever the interaction, it is SO important to keep it positive.

Rice Allergy - Is Rice Allergy Becoming A More Commonly Seen Allergy?

2010-11-24T18:00:00.000-08:00

Both my son and daughter have food allergies and my son also has FPIES (food protein-induced entercolitis syndrome). One allergy of his that we became aware of this past week is rice. It is not usually a common food for people to be allergic to, but according to this link it is on the rise:

Rice Allergy - Is Rice Allergy Becoming A More Commonly Seen Allergy?

Although I am glad to have figured out which food was the culprit, it is not an easy allergy to deal with when he already can't consume dairy, eggs, peanuts, almonds, and soy. It is a good thing he mostly drinks hemp milk! So many of the products for people with dairy, gluten, and soy allergies have rice flour as the substitute.

If you have some favorite products for people who suffer from these same food allergies, I would love to hear about it!

ZERO TO THREE: Playing with Babies

2010-11-19T18:56:00.000-08:00

Although it might be instinct to rock and comfort a crying baby, it is often not instinct to know how to play with a baby. The link below gives some great tips on playing with babies:

ZERO TO THREE: Playing with Babies

One of my favorite things to play with babies is "Peek-a-Boo"...so cute to see the look on the baby's face!

Resources on Sensory Processing Disorder - Free Downloads

2010-11-16T20:01:00.000-08:00

I am the handout queen...not really, it is just a title I have given myself. I love to provide families with handouts, website links, and other resources. When parents take the time to read up on topics that are related to their child's developmental delays, it is SO much easier for me to have a meaningful conversation with them about how to better help their child. My time with families is very limited, 1-2 times per week usually, and unfortunately this is not enough time to teach families everything they need to know.

One website that I am fond of is "sensory street". Here is a link to this site's resource page that includes many free downloads on topics related to nutrition/feeding problems and sensory processing disorder/ sensory integration dysfunction:

free sensory downloads

I especially like the download of "Do You Know Me?". Not only does it come in English and Spanish, but it is concise and easy to understand especially for visual learners. This handout can be given to family members, caregivers, teachers, and any other professional working with children with learning problems or other special needs.

Do You Have Any Idea of the Chemicals Used in Fast Food Chicken

2010-11-10T13:07:00.000-08:00

So many of us are uninformed of what actually is in the food we eat. This is the case when we eat "quick" meals at home out of a box, but it is especially the case when we eat fast food! Here is an article that hopefully will make you think twice about going through the drive-thru of a fast food restaurant:

Do You Have Any Idea of the Chemicals Used in Fast Food Chicken

The reason we go eat fast food is because so often we are too busy to cook after a long day of work and helping the kids with school work or toting them to sports lessons or other places. One thing I do is cook foods ahead of time and put them in the freezer. Then, I thaw the meal out in the refrigerator in the morning before leaving for work. This saves preparation time when I arrive home, and all I need to do is bake it! Other things I do is use the crock-pot or cook quick recipes with fresh ingredients. One of my favorite cook books has a big section on 15, 20, and 30 minute meals...this includes the time needed to prepare and cook it. And when I am working as well as a mom to two young children, I need all of the short cuts I can take without resorting to fast food! I would love to here what other people do to make nutritious meals in a hurry. Key words are "nutritious" and "hurry"!

Indoor Gross Motor Activities

2010-11-03T18:27:00.000-07:00

Today it is cold and rainy outside. That means my kids didn't get to play outside like they typically do before and/or after supper. Now that it's November, there will be more and more days like this where we have to be entertained indoors.

Here are a few ideas that I use to keep my kids involved in gross motor activities while staying indoors, and maybe they will work for you too:

1. "Simon Says": I usually start out as Simon while playing with just my 7 year old daughter, then my 2 year old son usually joins us and tries his best to imitate everything his big sis does. I tend to call out these commands: standing on one foot, animal imitations (bird, cow, donkey, bear, crab, snake, etc), twirling, jumping jacks, clap while jumping, tip-toe walk, heel walk, jump from side-to-side, clap hands over their heads or behind their backs, touch one hand to the opposite foot, and walk backwards.

2. Obstacle course: We have a big space in our living room and entry way that makes a great location for an obstacle course. We use our fabric tunnel, mini-trampoline, fabric tent, blankets draped over the back of chairs, large pillows, couch cushions, and a hula-hoop to either jump in-an-out of or to climb through. I have the kids go through the obstacle course consecutively together or to do it individually while "racing the clock". Motions involved include climbing over, under, and through, jumping forward and backward, crawling forward or backward, and rolling (log or forward).

3. Kids yoga or other exercise videos: my children's favorite video is from Yoga Kids (R); the poses on the video are fun and in alphabetical order, A-Z. "A" is a pose that looks similar to an alligator and "R" is a pose that looks similar to a rocking horse. The suggested ages are 3-5 years, but I think many 2 year olds can at least try it. My son probably is motivated to try the poses because his sister and I are doing them as well.

4. Chores: I completely believe in child labor and teaching kids to be responsible for chores! They are good for building strength and coordination! My kids help carry bags from the car as well as clean their rooms or any other area where they have played and made a mess. Both of my kids like to help fold towels, not that they are excellent at it, but at least they are active and trying! My older child is also expected to make her bed and help "set the table" before dinner.

5. Cooking: stirring batter and rolling out dough is lots of upper body gross-motor fun! Pounding over the food chopper can be quite a blast also!

6. Dress-up: My kids like to play dress up and then act out the character. We have costumes for Peter Pan, Captain Hook, various princesses, cowboy, police man, baseball, soccer, as well as random hats, scarves, and shoes to play with.

7. Playing games in various positions: I like to play card games with my daughter while we are facing each other and propped on our forearms lying on our bellies. I like to draw and color with my son while we are standing at his easel. It is also fun to draw while on paper taped to the bottom of a table or chair while lying under it, but I am not sure I trust him with this yet, maybe as he gets closer to 3 years of age! Sometimes my daughter and I sing songs while we are hanging off of the couch with our heads on the floor...can only do this one for a short amount of time!

8. Sing songs with body actions: "Wheels on the Bus", "Ants Go Marching", "Row, Row, Row, Your Boat", "Getty Up Horsie", and "Ring-Around-the-Rosie". These are fun as long as you have energy to keep up with your kids!

Use your imagination to keep the kids active! Just remember not to over-use video games and television during the autumn and winter months. Keeping kids moving is important for motor and cognitive development as well as to reduce chances of obesity!

For ideas of indoor activities for children with sensory processing disorder (SPD) or autism (ASD) known as a sensory diet, check out the following website www.sensorysmarts.com Also, ask your child's occupational, physical, and/or speech therapist for a handout on activities to do at home to keep your child busy. This will also greatly impact behavior because they won't be bored!

How to Choose a Halloween Costume for a Child with Autism | eHow.com

2010-10-24T18:06:00.000-07:00

Choosing the "just right" costume can make or break the Halloween holiday for children, especially children with sensory processing disorder (SPD) or an autism spectrum disorder (ASD). Here are some suggestions on choosing a costume:

How to Choose a Halloween Costume for a Child with Autism | eHow.com

A Halloween costume could be new with some of the considerations listed in the link above, or it could be something the child wears often such as a sports team uniform or "dress-up" play clothes. I would love to hear what worked for your child as a Halloween costume and what made it so successful!

Free Downloads on Sensory Processing Disorder

2010-10-19T17:58:00.000-07:00

Since October is Sensory Awareness Month, I thought that I would share an awesome resource which is a link to free downloads on sensory processing disorder (SPD):

SPD free downloads

Let's do all we can this month to make more people aware of the symptoms of SPD! One easy way to do that is to share handouts that are written in simple and precise language. More people are likely to read a one to two page handout than a long book. Go ahead, print some of these handouts off and pass them around to teachers, friends, parents, caregivers, and anyone else that could benefit from the information.

Nutritional Guidelines for Toddlers - iVillage

2010-10-15T15:36:00.000-07:00

Today I went to a 6 hour workshop on the topic of nutrition. The speaker presented on how important good nutrition is for exercise and muscle building. So, nutrition is on my mind! Since tomorrow is my assigned day to take snacks for my daughter's soccer team after the game, I couldn't help but analyze what snack would be the best post-exercise snack as I was listening to the speaker. I decided to bring G2 (Gatorade) and granola snacks. Getting carbohydrates, proteins, and hydration within 30 minutes of a work-out or sport activity is very important, as well as drinking fluid every 10-15 minutes during the activity. It's a good thing this soccer club blows the whistle in 10-15 minute increments for mandatory water breaks!

Good nutrition is not only important for active children participating in sports, but it is important just for normal growth and development. Many of the clients I work with need more calories than what is expected of their peers with no medical problems. This might be because of cardiac problems, prematurity, spasticity of the muscles, mitochondrial disorders, or various diagnoses that tend to burn calories at a higher rate than is normal. So even though this link I'm including is nutritional guidelines for typically deveoping toddlers, the information gives a baseline of what is necessary:

Nutritional Guidelines for Toddlers - iVillage

Many of the kids I work with are blessed enough to be seen by our dietician, but unfortunately not every facility has a dietician. So, I hope the information in the above-mentioned link is helpful to those who don't have access to a dietician or nutritionist who specializes in pediatrics. If the child you are concerned about (may be your child or a client) does not have a dietician or nutritionist because there are none in your area, it might be worth the drive and money to a facility in a nearby town (or even a far away town!), even if it is just once every month or two.

Children's Hemiplegia and Stroke Association

2010-10-13T19:08:00.000-07:00

Many children have hemiplegia due to cerebral palsy, a stroke, or any other injury to the brain. Hemiplegia is when one side of the body has abnormal muscle tone and tightness due to a brain injury or stroke on the opposite side of the brain. In comparison, hemiparesis is when the person has muscle weakness and "floppy" tone (AKA flaccidity) due to the same reason. This means if the person has a stroke on the left side of the brain, then the right side of the body will be effected. The person loses not only muscle strength, mobility of the joints, and coordination but also sensation. When a person doesn't have full sensation in a limb, then they tend to not use it. For adults with this problem if they have normal cognitive skills, they can force themselves to use the arm and leg on the involved side of the body. Also, an older child might be able to do this. But for infants, toddlers, and young children this is not typically the case especially if they had the brain injury in utero and never had typical movement of the involved side of the body. Physical and occupational therapists have strategies they can teach the child and parent to aid in the child using the arm and leg, but sometimes this just doesn't work, because the child wants to use the other side because it is easier to use and it has full sensation.

Some children who have hemiplegia may benefit from constraint Induced Movement Therapy (CIMT) which is the technical word used for "forced use". The following link has links to various articles and research that has been conducted on the effectiveness of this approach with children.

Children's Hemiplegia and Stroke Association

I had a co-worker about 6 years ago who was conducting her thesis on CIMT. She set up a summer CIMT camp at the clinic we worked at in which several school-age children with hemiplegia participated. They had their non-involved arm casted so that they weren't tempted to use it. This "forced" them to use their involved arm which was hypothesized to build strength, coordination, and sensation. Certain criteria had to be met just to participate, because if the child had too much spasticity or other problems then CIMT wasn't going to be able to help. CIMT is not for children who can't use the arm at all (complete paralysis); there has to be at least some movement.

The end results of the project were good. Although every child made progress, I am not sure that any of them achieved completely "normal" use of the involved arm, but I do know they all continued to receive weekly OT and PT to build upon the progress that was made over the summer.

I have not ever used CIMT with the toddlers that I work with at early intervention (ECI), because I think they would just be frustrated and confused. Maybe a child in preschool or early elementary age would better understand the purpose of CIMT and not get so frustrated. However, I do "hold" the involved arm down for an activity as well as place toys to that side of them so they are more likely to use the involved hand instead of ignore it. Other techniques I use with young children with hemiplegia or hemiparesis include: NDT handling, bimanual activities, electrical stimulation, dynamic and static splinting/orthotics, kinesiotaping, adaptive equipment, infant massage, and sensory integration therapy. My favorite dynamic splint for infants is the Joe Cool (TM) splint, but they tend to not be as effective with the toddlers because they have figured out how to unstrap the velcro! The most important thing in helping infants and toddlers with hemiplegia/hemiparesis is teaching simple therapy techniques to the caregivers and parents because they are the ones who are primarily with the child all day long. For some of my kids who attend daycare in large classrooms and have parents who work long hours, the techniques asked of the caregiver might be simple such as making sure the child wears his hand splint during table-top and "centers" activities. I also suggest that at snack and lunch time that food and drinks be placed to the center and each side of the child to increase the chance that he may use his more involved hand; if the food and drinks are placed only on the non-involved side, then the child is not likely to use the hand that needs to get stronger. These are simple and do-able suggestions! If I give complicated strategies, the caregivers are not likely to have the time to perform them.

Turning Everyday Items Into Therapy Tools

2010-10-10T20:39:00.000-07:00

This week has been one of those weeks that just flew right by: doctor visits, allergy shots, soccer practice and game, birthday party for my daughter (7th), work, and all of the normal things that happen in a week! So, I was just realizing that I haven't blogged since last week. I couldn't even think of anything interesting to blog about not that nothing interesting happened, but because it was such a busy week that everything that happened work-wise seems so long ago. It was about that time that I started the last load of laundry and realized what I should write about: laundry baskets and other everyday items. "Laundry baskets" are not ordinally the most interesting topic, but I'm going to discuss how they can be used as a therapy tool to help children with meeting their developmental milestones.

Laundry baskets:
1. When inverted they are an excellent item for children to push around the room. If the child can stand but not yet walk, this is especially a great activity because of their wide base of support the child gets lots of stability. For those children who can already walk and need upper body strengthening, pushing the basket across carpet can give some extra resistance.

2. Have the child sit in the laundry basket and take him/her for a ride. For children with a language delay, you can encourage them to say/sign "more" or "stop" as you push them across the floor. For children who need to work on social engagement, have another child push the basket and then they can switch rider-pusher in order to work on turn-taking and talking to a peer.

3. Have the child sit in the laundry basket as the basket is on an adult's lap. The adult can tilt, bounce, or rock the basket for vestibular input to work on balance/equilibrium skills.

Blankets:
1. Magic Carpet Ride: Have the child lay on a blanket as you grab one end of it and run across the floor. This is a perfect opportunity for the child to say he wants to go slower, faster, more, or "all done" with words or sign language. It can also be a turn-taking activity if there is another child; the child pulling is getting lots of proprioceptive input whereas the child who is lying down gets vestibular input.

2.Hot dog: Have the child roll up in the blanket as if he is the weiner and pretend that the blanket is a bun. Then, give the child deep pressure as you pretend to put different condiments on the "hot dog". Give joint compressions to the feet as you "shake on salt and pepper".

3. For infants and toddlers (or light-weight preschoolers), a blanket can be used as a swing. Two adults can each grab an end as the child lays in the center. They can bounce the blanket up and down or rock it side-to-side. The child can have his body perpendicular to the adults and then switch to being parallel to the adults in order to give input to different receptors of the vestibular system.

Large Bowls:
1. When inverted, they make wonderful drums! If you have plastic or wooden spoons, those make great drumsticks. But if you only have a bowl, the child can bang it with his hands as if it is a bongo drum.

2.Put a ping pong ball in a large bowl, then move the bowl in a circular direction (clock-wise). Stop, then move the bowl in the opposite direction (counter clock-wise). This is a great activity for eye tracking in a circular direction. For children with low vision or poor attention span, use contrasting colors such as a black bowl with a white ball. For eye-hand coordination, the child can try to stop it with his hands and grab it.

3. Have the child jump over the bowl pretending it is a "candlestick" while you repeat: Jack be nimble, Jack be quick, Jack jumped over the candlestick!

Socks:
1. Wad a pair of socks up to the size of a bean bag and use them for bean bag toss at a target such as a bowl, box, or any other item around the home. If you bounce them off of an exercise ball or mini-trampoline, they will go flying across the room...usually guaranteed to make the child laugh!

2. Empty a clean load of laundry out onto the bed or other clean surface and have the child sort the socks by color and/or design. This is great for oculomotor skills and the visual perceptual skills of figure ground, visual memory, visual discrimination, and form constancy, especially if there are other items in the pile besides just socks.

3. Put potatoes or other items similar in weight within larger socks and use them as weights for the lap or over the shoulder; good for proprioception and/or muscle strengthening.

There are SO many more everyday items that can be used therapeutically. What are your favorite activities to do with household items? I would love to hear your ideas!

October is National Sensory Awareness Month

2010-10-03T19:14:00.000-07:00

I have been happily surprised lately while talking to some of the staff at daycares and Mother's Day Out (MDO) programs where I work with some children for occupational therapy services. They ACTUALLY have heard about sensory processing disorder (SPD)...yeah, it is not a foreign concept to them! At one MDO program I was at last month, the teacher even asked me if I thought she should refer another child for an OT evaluation due to him possibly having sensory processing problems. Now before you get overly elated that the OTs in our community have done the most amazing job ever, I have to let you know that this woman has a nephew with Asperger's and SPD. But still, it was exciting to have her initiate the topic.

I live in a suburban area outside of a large city with a school district that is well known for its great support of children with special needs. In fact, there is a special program just for children with Autism Spectrum Disorders. You know what that means don't you? It means we have people moving into our district at increasing rates each year. It also means that many community members are more aware of learning disorders and other special needs than in some of the other places. Many of the preschools/MDO programs, daycares, and babysitter organizations go out of their way to be inserviced on learning problems and in particular SPD. Now, I am not going to go so far as to say us OTs and special education/ early intervention staff have done everything we can do to educate our community. Of course we haven't! Everyone can always do more.

If you would like some ideas on how to raise awareness of sensory issues in your community, go to this link that provides contact information for a free electronic packet full of ideas to help you:

S. I. Focus

Since October is National Sensory Awareness Month, I will be doing a little extra educating on the topic. I've already done a 90 minute presentation to the new staff at my job last week, and I plan to do something at least once a week this month to bring awareness to SPD.

I do public speaking quite a bit on various therapy related topics including SPD. One thing that I have learned is to keep it simple when explaining SPD to people who have never heard of it, but don't over-simplify it either. If you plan to go out in the community and speak to groups about SPD, then make sure you know your audience. A group of doctors may not need the same explanation as a group of elementary school teachers. Doctors tend to want to know about "proof" through research whereas teachers like to know the functional implications and simple strategies to help the children.

Good luck with spreading the word about Sensory Processing Disorder!

Occupational Therapy for Feeding Skills During Family Mealtime

2010-10-01T20:29:00.000-07:00

I have a lot of therapy strategies up my sleeve when it comes to pediatric feeding disorders. Some of them include fancy positioning equipment, oral-motor devices, stretches, and textured teething toys. Some of my strategies even require that I become "certified" just to use them. Yet, the most effective strategy that I have found so far is to show up during family meal or snack time for children and during a scheduled bottle feeding for infants. It sounds SO simple, but it works!

For many of the children I work with they can perform a certain skill such as munching a soft diced vegetable if I was to give them just a couple of pieces in between some mouth exercises at a time in which they were not even hungry. They might even be able to hold a spoon if we practiced scooping up toys out of a sand box while we are playing in their room. But that doesn't mean they have the muscular endurance and sensory processing abilities to chew three different foods on the plate while using utensils to feed themselves. It is hard for many children with feeding disorders to handle more than one food due to the various flavors, temperatures, resistances, and textures. Additionally, they may be able to chew the food, swallow the drink, and manipulate the cup and utensils when sitting alone, but can't handle it when there are more people present. Why is that? Well, every child may have a different reason, and I am not going to know "why" unless I directly observe the meal within the natural setting: family meal time. If that isn't possible, then I observe snack time.

What does family meal time look like? It is different for everyone. I tell the families to set everything up as if I wasn't there. The meal may occur in front of the TV on the couch with one of the three siblings next to the child I am working with or it may occur at the dining room table with every household member present. I just want to see what naturally occurs during the meal time routine...there is no right or wrong. For some children they may not be able to participate in family meal time because of the noise level. For others it might be that they are sitting too close to a sibling that keeps inadvertently touching them. Even after I observe family meal time, I may still not know why the child is having difficulty with eating. That is when I watch the child eat a variety of foods while he is alone. If I figure it out, then we may work on specific skills separate from meal time, but even then the intention is to include the child in family meal time. Some children may need some 1:1 work with oral motor exercises, fine motor play, a "sensory diet", and other strategies immediately prior to family meal.

For those kids who can't handle eating with their family, maybe they could at least sit and socialize or just "be" there, even if they have to eat before or after everyone else. Just "being" with everyone else at the table might be the only way a medically-involved or tube-fed child can participate, and that is okay.

It breaks my heart when I find out that the child with the feeding disorder is not included in any form or fashion just because he has a feeding disorder. If the child's sensory processing abilities don't allow him to be with the rest of the family, then maybe he could help with meal preparation or setting the table.

For babies with feeding disorders, I show up for occupational therapy at one of their scheduled feedings and watch the parent (or caregiver) feed the child. I offer suggestions if needed. I may follow up with stretches and ideas for pacing, positioning, burping, and nipple/bottle changes. If the child is having alot of problems, then I may feed the child. But the problem with that is that babies that are oral feeders get usually 6-8 bottles a day and I am not going to be present for all of those feedings! So, the natural routine of the meal is going to be the adult holding the baby (or placing them in a device) while feeding him. Sometimes I do the first half of the feeding process for training purposes, and then after the baby has burped I will have the parent try to do the same things I did. After all, feeding your baby is the most basic thing that every parent wants to do successfully!

I guess my biggest "take home point" from this blog entry today is try to work with the child within the natural routines. If the strategies given to the family aren't meaningful to them and feel like extra work, then they will not work on them between the therapy visits. On the other hand, if the strategies are purposeful and occur within routines they already have, then the family is more likely to use the therapist's ideas.

Nystagmus

2010-09-29T07:49:00.000-07:00

Nystagmus is when the eyes oscillate. This movement can be either side-to-side, up-down, or in a rotary motion. Nystagmus is a normal thing after a person has been spun in circles, but not when the person has just turned their head to the side or is sitting still. There are different reasons behind an atypical nystagmus (meaning not after being spun), but the most common reason I see it in children is when they have neurological damage. Here is a link that explains it well:

Nystagmus

Because the eyes are oscillating, often the children complain of things looking blurry when they look straight ahead. Since there is not a cure for it, children should be allowed to adapt in order to perform activities to the front of them such as reading and writing. The most common adaptation is the child tilting their head and looking out of the corner of their eyes. Now, this may be something we wouldn't want a child to do if they have other diagnoses such as hemiplegia/hemiparesis with hemianopsia or other one-sided problems. In those cases we would want to encourage the child to look to the middle of their body with the paper or book placed to the center of them. Just be aware that forcing a child with nystagmus to look straight ahead to perform table-top activities could give them headaches and cause them to be distractible....if everything I tried to focus on was blurry, I would lose focus quickly too! Fidgeting and grouchiness will soon follow the distractibility if forced to keep looking to the center. This is especially hard when dealing with toddlers and preschoolers because sometimes they lack the words to express that things look blurry, whereas older children can often tell us their symptoms.

Another accommodation could be to angle the papers that they are reading or writing on. Anywhere from a 30-90 degree angle could be appropriate. An example of writing on a 90 degree angle would be to draw on paper taped to the refrigerator. An example of a 30 degree angle would be taping or clamping paper on to a 3-ring binder that is declined, with the rings perpendicular to the child. Angles in between those could be achieved on a desk or standing easel.

When dealing with puzzles, artwork, or other fine motor activities it may also be appropriate for the child to be allowed to stand up to do the task and not be forced to stay seated. So often in daycares or Mother's Day Out programs I see that the little children are being taught to stay in their chair, but this may not be appropriate for a child with a nystagmus problem.

If the child with nystagmus is young and the pediatrician is not aware of it, be sure and share this information with them. Maybe a referral to a developmental optometrist, opthalmologist, or neurologist will be needed. If the child is older and hasn't been to an eye doctor lately, a referral to either the developmental optometrist or opthalmologist may be needed. Many developmental optometrists will write up reports full of functional information that can be shared with the daycares/schools and placed within an IEP.

Food Protein Induced Enterocolitis Syndrome - FAAN

2010-09-24T20:19:00.000-07:00

My kids have food allergies to dairy, eggs, nuts, and some food additives (dyes, nitrates) in addition to having reactions to soy products due to food protein induced enterocolitis syndrome. This may result in diarrhea or vomiting. The "allergy" test which looks at IgE levels will show up negative for an entercolitis problem. This type of entercolitis is seen when the person can't handle soy and dairy products. Entercolitis also differs from lactose intolerance because it is not due to lacking the enzyme lactase that breaks down milk sugar; it goes beyond having bloating and gas.

I am often surprised at how many pediatric GI doctors do not even look at this diagnosis as a possibility. Sometimes the parents of the kids I work with are told to give the child soy or dairy after the IgE test shows no positive sign of allergy. I think if the parent is seeing the child in GI discomfort, then the food shouldn't be added back into the diet. The allergist doctor that my children go to is the one that educated me on food protein induced entercolitis syndrome, yet my experience is that even some allergists don't look into this possibility. I realize though that every doctor has different trainings and experiences...wish more of them new about this possibility!

Food Protein Induced Enterocolitis Syndrome - FAAN

If you've not went to a doctor for your child's digestive or allergy problems, then please do. You may want to visit an allergist if your child hasn't got better and has already seen a GI doctor. Some of my clients have even needed to go to the neurologist to rule out other problems such as metabolic or mitochondrial disorders which can have an impact on the GI system. One thing that is important to do before the doctor's visit is to keep a food diary. List out what the child ate, what time, and if there were any behaviors or digestive problems (e.g. burping, vomiting, refluxing, diarrhea, constipation, gas). If you've done this for over a week, you might be able to see a pattern and figure out the culprit. Sometimes not, but then you are able to rule out which food is not the offender!

ZERO TO THREE: Aggressive Behavior

2010-09-20T19:56:00.000-07:00

I think that all toddlers can become easily frustrated from time to time. I know that my 27 month old son does! Overall, he is a laid back child. But since he began preschool three weeks ago, some new behaviors have arised. He has become more possessive of his toys while chanting "mine, mine!" and seems a bit more impatient, and even pinched another child after she "stole" a toy from him. How I and the staff choose to deal with these behaviors can make all of the difference in the world! I think these behaviors are normal for his age, but they should definately be redirected. Some suggestions on how to handle aggressive behavior are on the following link:

ZERO TO THREE: Aggressive Behavior

Children with developmental delays tend to get frustrated when they can't express what they want to say or when they become over-whelmed. That is when aggression may peek out in them...not because they are a bad child, but because they want what they want and when no one understands that, it can become frustrating! Many of the kids I work with become aggressive such as pushing, biting, or kicking when another child takes a toy from them. This is often because they don't yet have the ability to say "mine, mine". So, it may be frustrating that a toddler seems selfish, but it is better that they let you know they wanted that toy by saying "mine" than by pushing another child. If a teacher or other adult doesn't understand that, then the child may be wrongly punished. Although the child may need to go to time-out for hurting another child, he should also be encouraged to "use his words". I think that the suggestions in the link above mixed with suggestions by a speech language pathologist, occupational therapist, and/or developmental specialist (with ECI/EI)should help minimize the aggression in a child with developmental delay.

Brachial Plexus Injury in Infants, Health Facts For You, UW Health, University of Wisconsin Hospital, Madison

2010-09-16T19:14:00.000-07:00

Brachial Plexus Injuries can occur at any time in life, but the risk to babies is more likely to occur in the womb or during delivery. So often they are not obvious until the baby is a couple of months old and not moving the arm equal to the other arm, and sometimes not even moving the arm at all. Another symptom I see is that the baby's clavical (collar bone) starts growing more forward due to the nerve not stimulating proper bone growth.
Here is a link describing brachial plexus injuries:

Brachial Plexus Injury in Infants, Health Facts For You, UW Health, University of Wisconsin Hospital, Madison

If you are concerned that your infant does not move one arm as well as the other, please discuss this with your pediatrician. An evaluation with a neurologist may be necessary to rule out a brachial plexus injury. Other problems that it could be include hemiplegic cerebral palsy, torticollis (neck muscle), orthopedic impairments, nerve impingement, and other things that should be looked at by a physician. The baby may need physical and/or occupational therapy to help learn to use the arm better as well as to provide stretches/exercises.

Will My Baby Catchup? Growth and Prematurity

2010-09-12T08:37:00.000-07:00

When evaluating premature babies, I often get asked the question "Will my baby catch up?", and I found a good link that can answer that question in detail:

Will My Baby Catchup? Growth and Prematurity

After reading this link you know that it depends upon the situation of how quickly (and if) the baby will catch up!

Changing the Environment & Interaction Style to Help Kids with Developmental & Sensory Processing Delays

2010-09-10T08:45:00.001-07:00

I have worked in a variety of settings: school system, hospital, outpatient clinics (more than one), early intervention, and home health. I have been working in early intervention and home health over the past 6 years, because I have found it to be my "niche". Why is that you ask? Well, I believe that helping children in their natural environments such as the home, daycare, and other community settings is where the biggest changes will be made. Now I am not saying therapy clinics are a bad place; I have worked in those settings and thoroughly enjoyed it and know that most of the kids had fun there. But the main focus of working with a child in a clinic, is the child and his deficits. Yet, in their natural environments the focus is not only the child but all of the people that come into contact with him on a regular basis and how every one and thing can help. Isolating the child in a clinic to work on fine-motor, feeding, language, behavior or whatever other skills doesn't necessarily carryover to how the child will function in another environment in which all of those "therapy toys" are not present; it may carryover for somethings and it may not. In home health settings, a therapist helps the family utilize what they already have in the places the child will be at on a regular basis.

A recent example of what a difference I was able to make in a child's life was through teaching the daycare staff how to work with a particular young boy. He is almost 2 years old and has significant developmental delays as well as mild spasticity due to some complications with being born at 27 weeks gestation- "a preemie". He has limited range of motion in his upper body in which it is hard for him to raise his arms over his head. He also has difficulty with tight hamstrings- the muscles in the back of the legs. So, when I observed "music and movement" time at the daycare, I was able to help the teacher incorporate some stretches and movements that would benefit this child as well as his peers, including touching toes while sitting in the floor. Now, he will get to do these stretches 5 times a week since he goes to daycare 5 days a week and they follow the same schedule each day. In addition, we altered the chair that he sits in at lunch time to a shorter chair so that he can now independently climb in and out of the chair. Other areas that were helped were naptime, outdoor play on the playground, and "centers" for fine-motor play. By teaching the teachers how to adapt the activities, alter their interactions such as by saying particular phrases, and by altering things within the environment, this child became more independent. If I had seen this child in a clinic, my focus would have been to teach some of these skills but without meeting the daycare staff and watching the sequence of the routines, I would not have been able to help this child as much.

Another example includes a child I see at his home who has significant behavior problems, sensory processing problems, and a short attention span. By teaching his mom to set up activities that he can be independent with at a small table within her line of vision, she can now cook dinner without him "getting in trouble". In the past, this child only acted well when given immediate 1:1 attention by an adult. So, I taught Mom to help him with an activity, and initially be on the other side of the room from him. Then, she progressed to leaving for 1-2 minutes, which then led to her being away from his side for 5-10 minutes. Within no time, she was able to do this in the kitchen and successfully cook supper without any (or at least only at times) "meltdowns". If I had not been in the home to teach his mom this activity, and only told her how to do it, he would probably not have been successful with this. The first time we tried to leave his side as he played alone even briefly, she wasn't thinking "it was going to work". So often, the parents and other caregivers just need us (therapists and other professionals) to show them how to do something and then they can do it on their own.

In the past, I thought that when I worked in a clinic and typed up a home program full of suggestions that that would help; that may be the case for some families, but most need to be shown! Also, I was giving general suggestions even if I thought I was individualizing it, because I had never walked into that child's daycare or home, so how could I have been completely individualizing it! Really, I was giving exercises and strategies aimed at decreasing the child's deficits such as poor balance, hand weakness, etc. I now realize I was only helping such a small portion of that child's daily routines.

If your child receives private OT, PT, SLP or other services at a clinic or other place than the home or daycare, ask the therapist to come do one or more home visits. If that is not possible, make video recordings of the different routines that don't work well.

Infant Vision: Birth to 24 Months of Age | American Optometric Association

2010-09-08T18:11:00.000-07:00

Infant Vision:
Birth to 24 Months of Age | American Optometric Association

ADHD diagnosis and poor diet now conclusively linked in Australian study - San Francisco adhd | Examiner.com

2010-09-06T18:16:00.000-07:00

Something we all know, or at least think, has now become the focus of research. Eating diets of highly processed foods may contribute to ADHD:

ADHD diagnosis and poor diet now conclusively linked in Australian study - San Francisco adhd | Examiner.com

My husband has an aunt who told us about her quest to feed her children, especially her son, only "healthy" foods and no junk foods back in the late 1970's and early 1980's. She didn't have the luxury of the internet and reading some of the recent research about how to eat organic and "whole" foods. But she said all of her trips to the library and meeting with a dietician was well worth it. She said her son had got diagnosed with ADHD. He was constantly wiggling, impulsive, and had a short atttention span...school was not his favorite place. Then, when she omitted white breads and pastas, food dyes, fried foods, corn syrup, candy, and other highly processed foods, she said his behavior and school performance made a 180 degree turn for the better! I have such respect for her and all of her hard work to feed her family well. I am going down the same route as her, but I have it much easier in terms of gathering information yet I still find it hard. If it weren't for my children's food allergies, I may have never learned some of these things. So that is why I am actually thankful that my children have multiple food allergies and can't eat a lot of junk! They think fruit ice pops and sorbet are the best desserts...how many kids in the USA think that...not enough! So amazing that fixing our diets can impact behavior, school performance, and lessen the chances of childhood obesity. Wow, is that powerful!

Developmental disability, early intervention, developmental delays, autism screening and early intervention autism : First Signs

2010-09-02T18:15:00.000-07:00

If you are concerned that your young child may have autism, check out this great website that gives lots of information on early diagnosis and intervention:

Developmental disability, early intervention, developmental delays, autism screening and early intervention autism : First Signs

I would love to hear of any other great websites that you recommend for early detection of autism.

Caring For Boys Versus Girls

2010-08-30T16:53:00.000-07:00

I've always known that girls and boys develop differently especially in the area of language and play. Now that my son is 26 months old this statement has become an even bigger fact in my life. It is funny to watch how long my son can play with his race track, look at his airplane and trains book, and interact with balls and other rolling toys. He will complete a puzzle, scribble, interlock toys, and build but after completing it, he moves back to his train table. At that same age, my daughter would have stuck with the developmental toys for 20-30 minutes. Here is a discussion link on this topic:

A Place of Our Own: Caring For Boys Versus Girls

"Boys will be boys":
Just remember that a boy with a significant language or fine-motor delay is not typical, just as a girl with a significant gross motor delay isn't typical just because of their sex. They will have slight differences, but should still fall within the "typical" range. So, if that is not the case for your child, please discuss your concerns with the child's doctor, and if necessary ask for an evaluation with your local early intervention program (ECI, EI) or outpatient pediatric therapy clinic (speech language pathology, occupational therapy, and/or physical therapy).

Brain Gym - a program of physical movements that enhance learning and performance in ALL areas

2010-08-26T10:52:00.000-07:00

My daughter who is in first grade came home from school yesterday and wanted to show me what she learned in PE class and said it was going to make her smarter. She put her arms out in front of her then crossed them at the wrists, then folded them in toward her, balanced on one foot, and pushed her tongue up against the roof of her mouth. I quickly said to her, "Ahh, that's a Brain Gym movement". She was amazed I knew that movement and wanted to look at my Brain Gym books I have in our study. I love the exercises from Brain Gym, and they can be used on kids of all ages as well as adults, here is a link:

Brain Gym - a program of physical movements that enhance learning and performance in ALL areas

I have used many of the movements within my occupational therapy sessions. Some involve crossing of the midline to help integrate the two sides of the brain, deep pressure for attention span, and eye movements which aid in tracking skills needed for reading. The benefits of Brain Gym are numerous!

Sensory Friendly Films

2010-08-16T19:40:00.000-07:00

Tomorrow I am taking my daughter to go see Toy Story 3. She has seen it already with her grandparents, but she keeps saying that it is soooo good that I must go watch it with her; so I will. For her and I the loud volume, dark room, and any other extreme sensory experience is just part of the fun of going to the cinema. But for many children out there who have have special needs including sensory processing disorder (SPD) or autism spectrum disorder (ASD) the whole "sensory experience" is not so fun. That is why I think it is great that AMC entertainment has at selected theaters at least once a month "sensory friendly films":

AMC Entertainment

Some people aren't lucky enough to live in one of the locations of these theaters. So if this is the case, what are some things that can be done to make the movie experience not only tolerable, but fun? I think for the older kids, you could visit the theater at a time when no shows are playing so they can get used to the room- that is if they've never been before. For any child three years of age or older, you could write a social story about the whole movie experience to let them know what to expect; predictability helps to lessen anxiety which in turn lessens sensory defensiveness. If you aren't familiar with social stories, look it up, the idea was created by Carol Gray. Just remember to make the story positive and personal.

For the children with auditory defensiveness, try to sit in an area of the theater where no one else is sitting so that the noise made by other people is not bothersome; this may require going at an unpopular time such as in the morning. Also, ear muffs or ear plugs may dampen the sound. If the child becomes over-whelmed there is no shame in leaving, maybe come back another time and try again. For some kids it may take multiple attempts before they can sit through the entire movie.

For kids on special diets, check with the staff ahead of time and bring snacks they can have on their special diet which they tend to find comforting. Of course, I am reading some people's minds and thinking that you will just sneak those snacks in your purse!

Have any other ideas that have worked for you? I would love to hear about them.

Nurturing Parenting Programs - Stephen J. Bavolek, Ph.D.

2010-08-10T16:17:00.000-07:00

It seems like every time I sit down to read the newspaper, I see some HORRIBLE case of child abuse or even worse a parent killing their child or step-child. So sad because it is 100% preventable! Even though I don't work often with children who have been physically or sexually abused, I do from time to time. Unfortunately, many of the children I work with have special needs (physical and mental) and can't express this event to anyone else.

As a professional who works in the homes with families, I am put in a place of educating the parents not just on rehab. techniques, but also how to discipline and love their child. One program that is worth professionals being trained in to learn how to do this is the Nurturing Parenting Program. I love the philosophy of the Nurturing Parenting Program which emphasizes positive, nurturing interactions between parent/caregiver and children. This fits right in with my other philosophies as an early intervention occupational therapist and infant massage instructor. To find out more about the program, go to this link:

Nurturing Parenting Programs - Stephen J. Bavolek, Ph.D.

If we can help educate these parents on other ways to discipline their child other than physical harm, then maybe, just maybe, we have made the most important change in that family member's life!

In addition, those of us who are parents and/or professionals can always learn more strategies to use in our own lives!

AAPM&R - What is a Physiatrist?

2010-08-04T18:51:00.000-07:00

Physiatrists are doctors that help patients with their rehabiliation process. They are sometimes called "PM &R" doctors which stands for "physical medicine and rehabilitation". I often refer my clients to these doctors, especially when the child has multiple impairments including neurological, orthopedic, visual, and mental delays such as with cerebral palsy or certain syndromes. I also refer clients to them when I know something is going on with the child but I'm not sure whether to send them to an orthopedist or neurologist. I think physiatrists are well versed in different areas of disabilities therefore they may be the best professional to steer the family a particular direction. Here is a link to their professional organization:

AAPM&R - What is a Physiatrist?

I also think it is nice to have a physiatrist for the medically fragile child, because the need for adaptive equipment, assistive technology, and other functional items tends to get pushed to the bottom of the list for a sicker child, especially when the parents of the child have a variety of specialty doctors they are seeing on a regular basis. The physiatrist is the "one in charge" and facilitates the communication of all doctors and other professionals once the child is stabilized from the medical problems.

Additives in Food Aren't Good For Us

2010-07-31T15:14:00.000-07:00

My children not only have food allergies, but they are also sensitive to so many foods including additives and dyes. Their symptoms include irritability, over-emotional reactions, fatigue, and diarrhea. The foods they are sensitive to do not show up as an allergy on an IgE test. Many of the kids that I work with also have the same problem, but because they have developmental delays it is harder for them to tell us they have a tummy ache or we just blow off their tantrums as part of the developmental delay. The truth is that many of the processed foods, additives, and chemicals that are a part of our diet aren't good for any of us. I try my best to buy organic foods as well as natural products without trans-fats, dyes, yeast, and other additives; but to say that it is easy to do this would be a lie. It does mean that I spend a lot of time reading labels and investigating products on the internet before I go shopping. One website that has provided me with some great information is Feingold:

Feingold

Since 75% of our immune system is in our gastro-intestinal tract it makes since to treat it right and eat natural products without all of those additives!

Normal Growth And Development Of Premature Infants - Care Guide

2010-07-27T17:20:00.000-07:00

Recently, a friend of mine had her baby girl four weeks early. She had so many questions for me about what to expect for her "premature" daughter. Some included: Will she "catch up" soon? Will she be shorter than her peers? Will she always be at risk for respiratory infections? Will she ever sleep through the night? and the list went on. Here is a link to provide basic information on prematurity:

Normal Growth And Development Of Premature Infants - Care Guide

At work, some of the babies I work with were born only slightly early such as at 34-35 weeks gestation whereas other babies were born as soon as 24-25 weeks gestation. Obviously, the preemies who were born under 1000 grams at 28 weeks or sooner have many more health problems than those born just a month early. But either way, it is smart for the child to have a thorough developmental assessment with a local early childhood intervention (ECI) program once the baby gets to go home. ECI can help with developmental needs including feeding, motor, communication, and other delays that may arise.

How to Improve a Toddler's Balance & Vestibular Processing Skills During Play | eHow.com

2010-07-24T07:34:00.000-07:00

Typically developing toddlers like to defy gravity whether it be spinning around in Daddy's arms, swinging in the backyard, or jumping on the bed. But when a toddler has consecutive ear infections, sensory processing disorder, low muscle tone, or any other thing that impairs balance, movement may not be so fun for them.

Below is a link that gives ideas to add movement into a toddler's play routine:

How to Improve a Toddler's Balance & Vestibular Processing Skills During Play | eHow.com

The vestibular system, located in the inner ear, is in charge of balancing the body every time the head moves. Muscle tone, bones (orthopedic alignment), nerves, and the eyes also have a big role in balancing too. If something is wrong with any of those body parts, then the person can have poor balance. So, if your toddler is absolutely terrified of movement in some directions no matter what you do, then he may need an occupational or physical therapy evaluation to determine the cause.

Milk Allergy Facts, Symptoms - Facts

2010-07-21T15:49:00.000-07:00

Whether it be within my circle of friends, while at work, church, and even the grocery store, I seem to be a magnet for people asking me all about milk allergies. Since I've dealt with my daughter being allergic to milk since she was an infant (she is now 6 1/2 yrs old), I am usually able to answer the questions aimed at me. One resource I tend to give is the food allergy and anaphylaxis network:

Milk Allergy Facts, Symptoms - Facts

One thing that I have learned over time is that dairy is not just in food, but also skin care products such as lotion, shampoo, and soap. So, read ingredients on foods as well as anything that contacts the skin.

Pants on the Ground

2010-07-18T17:11:00.000-07:00

I chose to name this entry "Pants on the Ground" not because I am a fan of this silly song that made its debute on Amercian Idol earlier this year, but because of potty training. My son has recently shown interest in potty training. He rarely produces anything, but at least he sits on the toilet for a while multiple times a day, and tells me after every bowel movement that he needs to go to the potty. So, there is a lot of work to be done in my home, but his interest has been sparked!

One thing that I have done is begun to change his diaper in the bathroom while he is standing....unless it is a messy bowel movement, and then it is back to the wooden changing table to lay down! If he is standing as I change the diaper, then he gets the opportunity to pull up and down his pants before and after. Whereas if he is being changed lying down, he doesn't get that opportunity as easily. Since he likes to watch the other family members go to the bathroom, he is now getting the message that if he is standing instead of lying down that he is just like us. The more signals we can give to toddlers that they are "big boys" and "big girls" the more we are letting them know not to act like babies. And since babies wear diapers and big kids don't, merely changing the tot's diaper standing up and having them help participate in the process is one step toward successful potty training. Here is a link with some signs of readiness and suggestions for potty training:

Toilet Training-Home Treatment

Many of the kids that I work with for occupational therapy would have difficulty pulling their pants up and down whether it be because of orthopedic, visual, or neurological problems. So if this is also the case with your toddler, maybe you can have them participate in a different way. It might be helping pick out "big boy" underpants at the store or it might be choosing which of the bathrooms in the home to go to (as long as the home has 2 or more toilets!). Another thought is to adapt their ability to pull up and down their pants. More than once I have sewn loops inside the front left and right sides of young children's pants for them to have something to grasp. This is especially good for kids with limited wrist motion or strength. The sky is the limit when it comes to adapting a routine. Just keep the mindset of keeping the child actively involved in the process!

Expanding Food Choices of Toddlers

2010-07-16T17:56:00.000-07:00

My 25 month old son used to eat "everything under the sun", but over the last three or four months he has been a bit pickier about his food choices. At times, he refuses foods he typically likes. Unfortunately, this is part of being a toddler and exerting his independence. Since I know that, I still offer the food but I don't create a power struggle. If he tries to throw the food, I just tell him to keep the food on his plate. Looking at it on his plate reminds him that the food still exists. Typically, he will eat that food a different time, so at least he still eats it sometimes. Now, if I weren't an occupational therapist who works with toddlers I might approach the situation differently, especially since I came from a home where we were told to eat everything on the plate or we couldn't get dessert and/or couldn't get up from the table until the plate was clean!

One thing that seems to work on introducing new foods to my son is having him sit at the table next to his older sister and watch her eat. Thank goodness she isn't a picky eater! Until this week, my son wouldn't eat green beans (BTW I don't like them either). But my daughter LOVES them, so I cook them at least a once every 7-10 days. Over the last couple of months, he went from saying "no beans" to allowing them to sit on his plate without saying anything; then he progressed to touching them and bringing them to his lips. Well, on Monday night I cooked green beans and he ate two of them willingly as he watched his sister eat them...yeah! Then, the next evening I heated up some left overs and not only did he eat the 5 beans I gave him, he asked for more of them without being prompted...yeah, again!

I think toddlers learn from older children whether it be a sibling, cousin, neighbor, or another child at a babysitter's home or a daycare. So consider pairing up the picky toddler with the not-so-picky eater who is older during snacks and meals. Even if it doesn't help right away, the child is looking at the food. Research shows that parents and caregivers give up to easily on getting a child to eat a particular food, and that on average it takes 10-15 presenations of that food before the child will like it. Now, if you force the child to eat it, I can almost guarantee it will take even longer! Toddlers like things to be their idea not yours, and repeated offerings of a particular food increases the chance that one day that toddler will choose to eat it. I do think there comes a point where you may have to conclude that the child just doesn't like that food for whatever reason: color, smell, shape, taste, texture, etc. After all, I don't like every food on the planet either!

Other ideas to expand the food choices of toddlers include:

- Don't get in the rut of fixing the same meals over and over. Not that it isn't okay to repeat some of the same meals, but introduce new foods as often as possible. This may take planning ahead so that you have new foods in the pantry and refrigerator. Even mixing meals up helps somewhat, for example: sometimes corn is served with chicken and carrots, and other times it is served with turkey and rice. This helps reduce the rigidity that some toddlers tend to exhibit.

- When offering new foods, try a food that is similar to a food the child already likes. For example, if the child loves Gala apples, then try different types of apples such as Macintosh, Fuji, and Golden Delicious. Also, pears have a similar taste to apples too. Another example might include that if the child likes plain apple sauce, then try cinnamon apple sauce or peach apple sauce; the taste may differ slightly but the texture will be the same.

- Be creative and fun with snacks and meals. Using cookie cutters to cut sandwiches into child-friendly shapes worked like a charm for getting my daughter to eat a turkey sandwich for the first time back when she was a toddler. After doing this for 4-5 times I just presented her with a plain sandwich, no special shapes, and she ate it just as quickly as if it had been in the shape of a heart. Other ideas might include drawing smiley faces out of ketchup onto a piece of meat and putting food onto a plate with the child's favorite character on it.

-Make sure every meal has at least one food that the child likes and don't force him to eat the others, just encourage it. At the very least, the child needs to look at it and smell it. Now, if the the child has an autism spectrum disorder or sensory processing disorder, then just being in the same room as that smell may be all they can handle at first, but the ultimate goal is getting that food on the child's plate so that one day he may actually eat it and like it.

- Have the child help cook the meal. When I make home-made pizza both of my kids help. My son obviously can't help as much, but he rolls out the dough with the rolling pin whereas my daughter can spread the sauce. I leave the oven light on as it is cooking for them to peek at here and there, and both kids are super excited about eating the meal by the time it comes out of the oven.

-Encourage the child to eat healthy foods such as fruit and vegetables as opposed to fried fast food. This means be a living example, because "monkey see, monkey do"; so if the rest of the family eats junk food and is picky with vegetables, then the toddler won't be any different unless the other familly members change their habits. This lifestyle also sets the child up to be at risk for obesity and diabetes. Type 2 diabetes in children is on the rise, and it could be prevented by healthier lifestyle and food choices; on the other hand, type 1 diabetes is acquired in childhood (usually) and isn't due to being over-weight.

- If your child has feeding difficulties due to sensory or motor problems, then consult with an occupational therapist or speech pathologist who specializes in feeding. Not all therapists are experts in feeding, so shop around until you find a good fit!

- Read the book "Food Chaining" which is written by feeding specialists and gives great ideas on how to introduce new foods slowly. If the child is just a picky eater with no oral aversions or oral-motor problems, then suggestions from this book alone may help. If there is something more going on, then direct therapy intervention should be considered.

Wow, all of this talk about eating has made me hungry for a snack...got to go!

Fidget Toys

2010-07-11T21:03:00.000-07:00

My family and I just returned from a week long vacation (3 hours ago to be specific). The one thing that helped my husband and I survive the 9 hour drive each way with two young kids was bags of toys, including fidget toys. I had a large bag of toys for each child to sort through and play with. So when my son got tired of playing with his cars, magna-doodle, and puzzle, the fidget toys were his next choice. He especially liked the stretchy, light up caterpillar fidget. On one of the "pit stops" I purchased a visual fidget; it is a 5 inch ball with a small fish and glitter inside it.

The term fidget basically just describes what a person would do with that toy...fidget. Fidgets are fun to turn around, pull, squeeze, shake, etc. Some children can benefit from them in the classroom to help them "wiggle" with their hands instead of getting out of their chair. For some kids, they have to be moving in order to listen or they zone out, so a fidget allows them to still be moving, just it is with their hands instead of their entire body. Fidgets are also beneficial for long car rides or waiting in doctor's office lobbies. When the child is playing with it, it keeps their mind off having to keep their body still. Some fidgets are textured which stimulates the tactile sense, whereas others are aiming at the visual, auditory, oral, or proprioceptive sensory systems. But you have to be careful with the auditory fidgets depending upon where you will use it, because you wouldn't want it to be too loud! Although fidgets are beneficial for many children, they are especially helpful for kids with sensory processing disorder (SPD), autism spectrum disorder (ASD), and ADD/ADHD.

Some things I had for my 2 year old son in his fidget bag for our long car ride included: small cars, fuzzy ball, stretchy caterpillar, zip up bag full of various action figures, wind-up fish, mini See-n-Say, aquarium tubing (for chewing), and other odds-and-ends that were too large for him to swallow had he decided to put them in his mouth. I'm not going to falsely say that for the entire 9 hours my son forgot he was strapped into his car seat against his will and was as happy as a lark, but I will say when he fussed, having toys as a distraction helped immensely! Now for my six year old daughter, she enjoyed her bag of toys also, but she has always been a champion traveler and wouldn't fuss even if she had nothing to do at all. But the fidgets made it more fun for her!

Still not sure what to use with your little one? Here is a link I found for some fidget toys that might stimulate some thought:

Toys for Learners: Trainers Warehouse Product Departments

I have also seen some great fidget toys at Walgreen's, Wal-Mart, and other retail stores. The dollar stores sometimes have good fidgets- just have to dig! Try to get a variety of fidget toys, because what works at one moment may not at the next, so it is nice to have quite a few in your bag of toys. I even save party favors from birthday parties my children have attended and toss them into the bag of toys. You might even want to go through your children's toy boxes to find fidget treasures. Another thing that makes good fidgets is the toys that come with a child's meal from a fast food restaurant as well as the prizes from cereal boxes. One of my favorite fidgets came from McDonald's over 4 years ago; in fact, I would go through the drive through to buy more kid's meals just for more of this toy; it was one of those intriguing toys that helps visual and fine-motor skills. By the way, I rarely eat fast food!

Toothbrushing Tips

2010-07-02T17:20:00.000-07:00

Just the word "toothbrush" can raise levels of anxiety in some parents. Especially the ones who feel as if they either have to force toothbrushing on their kids or just go without doing it. Kids with oral aversions, sensory processing disorder (SPD), and autism especially have a difficult time with teethbrushing. Add the toddler stage to those diagnoses and the resistance to the routine is even stronger!

I know that when my own two kids have had a long, over-whelming day the toothbrushing routine (as well as bathing and sleeping) doesn't run smoothly for us either! Here are some tips from Marsha Dunn Klein on the Meal Time Notions website to make it run more smoothly:

http://www.mealtimenotions.com/GuestOpinions/12-2009Toothbrushing%201-2-3.pdf

I think that when this routine finally starts to go smoother, it opens up the door to try other strategies with other routines such as dressing, bathing, and meal time. If these tips don't help, ask your occupational therapist for some home strategies. If your child doesn't have occupational therapy, maybe it is time for an evaluation!

How to begin a GFCF diet on a budget | eHow.com

2010-06-30T17:46:00.000-07:00

I've semi-perfected the art of cooking for my two kids "special" diets because of their food allergies. One trick I think that works is to cook recipes from vegetarian cookbooks because there isn't any eggs, dairy, or other artificial additives in the recipes. I just eliminate the nuts from the recipes that call for them. Another thing I did in the beginning was to spend HOURS reading ingredients on store bought food boxes as well as ingredients in regular recipe books or online cooking websites. I investigated the meaning of words such as "albumin" is a word for eggs, "durum" is a word for wheat, and "casein, whey, and lactose" represent dairy.

It can be over-whelming to start any new diet, especially if the child is a picky eater. Whether a parent is starting their child on a gluten-free casein-free diet or any other special diet because of food allergies or due to health reasons (celiac, autism, diabetes, etc.), it can be expensive and over-whelming to know where to start. This link gives a few ideas on how to do it and save some money:

How to begin a GFCF diet on a budget | eHow.com

I wrote this article over a year ago. I would love to have your comments on what worked for you. But I do think any parent of a child on a "special" diet will tell you that it takes alot of time and energy to figure out what the child can safely eat, then after awhile it becomes second nature and isn't too difficult.

Social- Emotional Milestones for a 24-36 Month Old Child

2010-06-26T14:45:00.000-07:00

Many of the children I work with have global development delays, including social-emotional development. Here is an excellent hand-out for parents and caregivers to understand what a 2-3 year old child should be doing in the area of social-emotional skills:

http://main.zerotothree.org/site/DocServer/socemot_-_24to36_-_parents.pdf?docID=10763&AddInterest=1503&JServSessionIda004=r6c8fpkup1.app216d

Although parents of children who receive an early diagnosis of autism seem to be aware of their child's delays of social-emotional skills, my experience is that parents of kids with no diagnosis or a diagnosis other than autism don't seem to be as clued into this area of development. Many times the parents assume the child isn't playing with his peers appropriately because of his language and/or motor delays. But kids with delays in those areas often still play with their peers okay if that is the only area of delays. I think many kids have to literally work on these skills listed in this link. That might mean that a child with no siblings who stays at home with his mom all week, be exposed to other children on a regular basis such as going to the same park on a regular basis as well as to story time at the library, playground in the shopping centers, and MDO (mother's day out) program for 1-3 days a week for 5 hours each of those days. Play dates and play groups are also good especially if the child doesn't have other neighborhood kids to play with or young relatives that he sees on a regular basis. If all of these strategies still do not help, then an evaluation with a psychologist, occupational therapist, or speech therapist may be necessary. Another good suggestion is to receive a comprehensive evaluation with the local early childhood intervention (AKA EI or ECI) program which will evaluate and work with children up until their third birthday. If the child is almost 3 years old or older, then an evaluation by the public school could be beneficial. Also, look to see if your area has an early headstart program with any openings.

Reflux (GERD) in Babies & Young Children

2010-06-26T14:14:00.000-07:00

I've blogged more than once on my personal experience of having a baby with severe reflux. But when I saw this article I just knew I had to post it and review my story once again:

http://www.zerotothree.org/child-development/health-nutrition/29-3_pulsiferanderson.pdf

My now 24-month old son took two reflux medications up until the age of 14 months. But lets rewind all the way back to the beginning. Starting at about one week of age he started spitting up a lot and when I laid him down in his bassinett he would cough on the spit up...quite scary, because I was afraid he would aspirate and die! So, I elevated the bassinett, added a wedge, and that still didn't work. The only way he could sleep without "choking on his spit up" was to lay on my chest as I was in the reclining chair or in a reclined bouncy seat. So starting around 3 weeks of life he started Zantac, an antacid. That medicine made him less grouchy, but he still refluxed up massive amounts of breast milk (he never had formula). In fact, we nick-named him Milkshake! Then, the pediatrician switched him to Prevacid, a proton-pump inhibitor, and my son did better with that medicine but still spit up alot, but at least he was a happy spitter. If it weren't for his sudden decrease in weight gain at that point we wouldn't have been worried. I pumped breast milk and was making plenty, so that wasn't the problem. Since his sister had food allergies and his bottom was red alot, I took him to see the allergy doctor hoping to get some answers. The doctor said he had to wait until my son was 6 months old to do formal food allergy testing, but until then I was to not eat the common culprits of eggs, dairy, and nuts. Guess what, my son spit up WAY less after I quit eating those foods! By the way, his food allergies were way more than those three and still are, but those were the biggies. Yet one other problem still remained, he would spit up even two hours after a feeding; so that suggestion of elevating/positioning the baby for 30 minutes after a feeding didn't work for us. The pediatrician then put my son on erythromycin, an antibiotic, as a prokinetic to speed up the motility of the stomach emptying into the intestines. He gave me the choice of Reglan or Erythromycin and I chose the later because of so many of my patients having lots of side effects on Reglan. Well, this medicine made all of the difference in the world. He started gaining weight and spitting up less, but still did spit up some. At this point, we were only using 2 burp cloths a day, whereas in the beginning we would go through no less than 5 or 6 a day! But soon after we introduced baby cereal and pureed food. I was hoping this would help him spit up less, but it didn't, and in fact, he spit up more. It wasn't until after my son was walking that we could go days without the medicine and him be okay. I think between gut maturity, age, and muscle strength of the abdomen he finally got better. Having said all of that, I do believe that for many babies, one medicine or positioning helps. For others they get better when cereal or purees are introduced. I'm sure much of my son's problems were the food allergies. Not too many of my patients have as bad of a case of GERD as my son, and thank goodness! Poor child couldn't sleep flat until 5 months of age! Every time I tried, he coughed, gagged, spit up, cried, and couldn't fall asleep. So glad that his head shape didn't suffer too much from sleeping for so many months in positioning devices! I contribute that to all of the sidely, tummy time, and upright sitting he did during his waking hours! Although I like this article I linked to at the top, I also like the book "Colic Solved" by Bryan Vartabedian, MD, because it explains things in simple language yet it is thorough and an easy read.

Fussy Baby

2010-06-24T19:41:00.000-07:00

I have a friend with a young "fussy" infant. She asks me for suggestions quite often. When she calls to complain I think that she secretly wants me to come rescue her...of course, if I was sleep deprived I probably would hope for the same thing! Not that I mind babysitting from time-to-time, it is better that she learn to calm her own baby. So this post is dedicated to my friend "R". Instead of me listing out everything I tell her, I thought I'd just post this link since it puts it so well:

Fussy Baby

Hope these ideas help! But if they don't, discuss the baby's symptoms with the pediatrician because there could be something more going on than just colic!

Sense-Able Beginnings: The Importance of Touch for Newborn Development

2010-06-24T19:21:00.000-07:00

Sense-Able Beginnings: The Importance of Touch for Newborn Development

Hidden Treasures in My Neighbor's Trash

2010-06-22T18:08:00.001-07:00

I pride my self in not being a pack rat. In fact, I donate unwanted items to charities on a regular basis. Anyone who knows me well knows I organize everything: my desk at work, my closets in our home, the garage, the kitchen, the kids' toybox, and the list goes on. I've been this way since I was young; I credit my mom who is also a natural organizer. So, it is not a natural instinct for me to tell someone I want to keep what they are throwing away. For me to say that means I must really think it is special! Typically, in my eyes another person's trash is just that, trash!

Today at work (early childhood intervention) the developmental specialist (EIS) who has a desk next to mine was clearing out all of her belongings from her desk shelves and drawers. She is only going to be my co-worker until the end of June, and then she is going into another field of work...sob, sob, sob because I enjoy her company! She won't be working with kids any more, so she has no interest in numerous inservice handouts and journal articles on children with disabilities. Of course I was touched that she saved handouts from my inservices as far back as 2004, until I realized she saves EVERYTHING...not sure she knows we have an industrial sized shredder in the next room over! Yet, I feel like the manuals and journal articles that I rescued from the trashcan were worthy of my reading one day. I took home two inservices manuals that looked particularly interesting; the subject of one is working with infants with auditory impairments and the other is on infants with visual impairments. I started reading the handouts (from 2002) and was impressed with the information except for the "resources" on the back page because many of the listed websites aren't even up on the internet anymore...what a shame! But at least the activities, checklists, and technical explanations are still accurate. But one website was up and running and it linked to all of the state's (USA) schools for the blind. Then, those sites linked to many other sites. If you are like me, you may begin reading one website and then ten minutes later you realized you've clicked on so many links that you aren't even sure where you began. The following link on babies with visual impairments was one of the links that seemed interesting:

http://www.wonderbaby.org/articles/reaching-for-toys.html

Well, I'm off to go get my 3-hole hole puncher and 3" three-ring binder from upstairs so I can file all of these handouts that I consider as "hidden treasures from my neighbor's trash."

Do newborn infants have a sense of rhythm? | Psychology Today

2010-06-22T16:19:00.000-07:00

I'm posting an interesting article on newborns and rhythm. I'm thinking that the babies have learned to listen to the beat of their mom's heart in the womb. It would be interesting to test premature newborn babies and see if they have a sense of rhythm as well...of course, it would be hard to find subjects since medical staff have other concerns much greater with these babies!

Do newborn infants have a sense of rhythm? | Psychology Today

I'm also thinking it would be interesting to find out if a baby didn't test well for a sense of rhythm would it correlate to a future auditory processing or motor planning problem in later childhood...hmmm, food for thought!

Amazon.com: IQ Preschool Lace up Pup: Toys & Games

2010-06-21T18:22:00.000-07:00

Stringing beads isn't as easy as it looks. It takes two hands, and each one has to do something different than the other one. Then, if it is a fat string and a small hole, it requires shifting repetitively with the thumb and index finger. So many of the little children I work with can't string beads whether it be due to stiff fingers, weak muscle strength, low vision, or a poor attention span. That is why I am always looking for toys that are adapted or easier for a special needs child to succeed. A few years ago while I was at an OT home visit, I fell in love with the lace up pup toy that the little boy had in his toy box. It has large holes which makes it easy to stick the lace through. It also has a wooden "needle" at the end to help the string go in the hole better, as well as tucking it back through the end when you are finished with the activity...no more lost beads! Here is a link that has a picture and purchase info:

Amazon.com: IQ Preschool Lace up Pup: Toys & Games

I own the pup, but it also comes in a snake. My two year old son loves to play with it. When he lets me sneak it away from home, I take it on home visits to use with some of my clients. "Testing" toys out allows the parents to decide if they want to go buy it or not...I always hate to suggest buying a toy unless the child has tried it out first. Lately, I have seen children with diagnoses of cerebral palsy, down syndrome, and autism be successful with this toy whereas they weren't with other stringing bead sets. I'm not making any money off of suggesting this link, it just happens to be one of my favorite toys in my "OT bag".

What You Can Do to Support Your Baby's Language Development from Birth to 12 Months

2010-06-17T19:28:00.000-07:00

My daughter just finished kindergarten two weeks ago. She would have been fine with going to school all summer long without a break because she loves school and everything about it: bus ride, recess, lessons in her main classroom, lunch, art, PE, and music class. Lets see if she still feels that way eight years from now...I hope so! When I think back about how I instilled in her a desire to learn, I think back to books. I read to her, labeled pictures, and let her "read" to me starting before her first birthday. I am doing the same things with my two year old son, and I hope that one day he loves preschool and elementary school as much as she has. The following link gives some ideas on how to develop language and literacy early on:

ZERO TO THREE: What You Can to Support Your Baby's Language Development from Birth to 12 Months

I think that many of the families of the infants and toddlers I work with do a great job of some of the suggestions listed in this link. The ones who do not often do not have books or educational toys maybe because of not having enough money or not understanding their importance. For the ones who can't afford books, I suggest going to the library (free) or dollar store (low cost). And for the families who think the child is too young to start looking at books, I provide handouts such as a copy of the link above or I show them the simple books I have. When I bring my books, I show the parents the response and interest the child has...that usually changes their minds and they realize the child is never too young! Sometimes the musical books in which you touch a button and a song or noise occurs gain the infant's attention. Other good choices of books include the ones with tactile pages such as fur or fuzz over the picture of an animal. Experiment with what gains your baby's or toddler's attention. Eventually, you will want to progress to small simple picture books with no noise or item to feel. You don't even have to read the book word for word, you can begin by pointing to pictures and encouraging the child to turn the page in order to be an active participant.

Sometimes books aren't offered to the children that I work with because of their special needs. But I have learned to make many accommodations for different disabilities. For example, for a child who has limited finger movement, foam pads can be placed between each thick cardboard page to make it easier to turn the pages. For children with limited head/neck/trunk movements, find a location to place the book that is easiest for the child to view it such as propping it on an easel in front of the child. For some children, maybe they will not be able to point to a picture, talk about the book, or turn the page, but they can at least listen to the adult read. If you think they can't understand you, still try. Maybe if the child is cuddling with the parent while being read to then at least attachment/bonding are occurring!

Too Many Infants Short on Vitamin D: MedlinePlus

2010-06-15T16:38:00.000-07:00

Hope people are taking their babies out in the sun and giving vitamin supplements daily, because lack of vitamin D can occur in both breast-fed and formula-fed babies.

Too Many Infants Short on Vitamin D: MedlinePlus

Ask your pediatrician for a recommended brand of supplements!

What Is Dyspraxia? How Is Dyspraxia Treated?

2010-06-12T16:26:00.000-07:00

I was thinking about dyspraxia today. Mostly because I was watching my 2 year old imitate nearly everything his older (6 yrs) sister did. This morning, he didn't want to eat his apple until he saw her eat an apple. He didn't want to brush his teeth until he saw her do it. Then, as they played upstairs it seemed like he had no problem joining her play and doing what she did. As they were stacking blocks, she decided to get creative and build a "telephone" out of the blocks. Once finished, she "talked" on the phone. I expected him to build a car or house as he usually does, or even attempt to imitate her telephone structure...but he didn't. He built a camera. That's right, a camera! It caught me off guard when he came up to me with his connected blocks, put them to his eye, and said "cheese". I laughed of course, and told him I liked his camera; he then repeatedly said "camera'.

This whole scenario would be too difficult for some of the young kids I work with, for various reasons but mostly due to poor motor planning (aka dyspraxia). Good motor planning includes the ability to imitate another person's actions as well as sequencing out the steps to a new task and making coordinated movements with the body. All too often young kids with developmental disabilities have to be taught how to play, so the above scenario would be hard. It took visual memory, expressive language, motor planning/sequencing, imitation, sensory processing, fine-motor, cognition, and social-emotional skills. For a checklist of detailed signs and symptoms of dyspraxia for various age groups go to:

What Is Dyspraxia? How Is Dyspraxia Treated?

I've seen many kids with dyspraxia make huge gains, especially when their family and school understood what it was. Often, extra repetitions of teaching a task, patience, and lots of sensory input help the child learn. Occupational therapy is usually beneficial, and since some of the children have language delays also, they can benefit from speech therapy. It is important to find something the child is good at to boost their self-esteem. This doesn't typically include a sport such as soccer that requires the person to motor plan their actions against a moving ball and other moving people. Sometimes non-competitive activities such as karate, piano playing, and art classes are beneficial.

Help Kids Hear - Facts & Figures About Hearing Loss in Children

2010-06-10T21:34:00.000-07:00

Help Kids Hear - Facts & Figures About Hearing Loss in Children

Over-Stimulation Can Hinder Feeding Skills

2010-06-10T21:20:00.000-07:00

My son had a runny nose today and was grumpy for the most part. Guess what...he wasn't that hungry! This boy LOVES to eat, so that is how I know when he is sick, because his appetite is less than usual. My two year old son is no exception from other kids...the appetite is the first to go and last to return.

Kids and babies with special needs especially tend to be less hungry when they are sick or when they aren't feeling well. "Not feeling well" could be a temporary state such as being upset, having indegestion, breathing fast, being tired, and the list goes on. I think for babies with sensory processing problems, especially those with medical needs or prematurity, it doesn't take much to make them feel "not well". It could be something as simple as gas, reflux, or over-stimulation. The following link includes signs of over-stimulation that a baby may display. This is important to know, because until a baby is calmer, he probably will not have a good sucking pattern, especially if respiratory problems exist.

Alertness & Crying

Also included in this link are the arousal levels of a baby. Studies show that babies are more coordinated with their sucking patterns when in a quiet alert state or even a bit drowsy, but not as well in the other arousal states (deep sleep, light sleep, active alert).

Vision Development - Children - Milestones in Vision Development

2010-06-08T16:44:00.000-07:00

Everything about vision intrigues me. The color of eyes, how they work, how kids develop vision, and the list goes on. Vision is so important; it impacts not only fine-motor skills, but balance, communication, social-emotional, sensory processing, and cognitive skills. I'm posting this link, because I think it is important to consider these main visual milestones:

Vision Development - Children - Milestones in Vision Development

If you are concerned of your children's visual skills, discuss it with their pediatrician and ask for a referral to an eye doctor; depending upon your insurance, you may not need a referral. Be aware that an optometrist and an opthalmologist are not the same thing. An optometrist goes to optometry school (OD) and mostly deals with testing of near/far vision to identify the need for glasses/contacts; some do other things such as looking at the general health of they eye such as for glaucoma, macular degeneration, etc. An opthalmologist is a physcian (MD) who specializes in "eyes". Even though they can fit a person for glasses, they are looking for diseases/health of the eye and perform surgery if needed (e.g. for strabismus). Other eye professionals: 1. Optician is the professional who makes and fits the eyeglasses. 2. Developmental Optometrist: helps kids with learning problems or other disabilities to learn to use their eyes functionally, such as to not ignore an eye or to have fluid eye motions while reading. 3. Visually impaired (VI) teacher: works for school systems and early intervention programs with kids with a diagnosed visual impairment. 4. Orientation & Mobility (O&M) specialist: similar to VI teacher but emphasis is moving in environment around obstacles. 5. Dyslexia or reading specialists: private centers or school system professionals who have special training in these problems. Dyslexia is considered a learning problem (the brain) not a problem with the structure of the eye.

The Most Common Infant Disablities and How to Recognize Them

2010-06-04T21:14:00.000-07:00

Here is an article I wrote a while back. It provides a list, statistics, and description of the most common disabilities seen in babies/ children.

The Most Common Infant Disablities and How to Recognize Them

It also provides links to books on some of those particular disabilities.

Dogs And 2-Year-Olds Limited In Ability To Understand Unfamiliar Pointing

2010-06-04T06:24:00.000-07:00

My "baby" boy will be two years old this weekend...sob, sob, sob! I remember his birth so clearly, yet when I really think about it, it does seem like two years have went by. So, in honor of his birthday, I went searching for interesting articles on 2 year olds. I beleive that the following link qualifies as interesting. The topic is how dogs and two year olds respond to gestural communication from adults in a similar way:

Dogs And 2-Year-Olds Limited In Ability To Understand Unfamiliar Pointing

Before my children were born, my dog was my "baby". I definately think that my adorable cocker-spaniel acted similar to a toddler!

Do colicky babies have sensory processing problems? | Family Anatomy

2010-06-02T04:51:00.000-07:00

"Colic" is just a description of a babies behavior...lots of crying for a certain amount of time. This term is not a clinical diagnosis. So often I see that babies with reflux or other digestive problems get labeled as colicky until they get treatment (e.g. formula change, medication, positioning, etc). But sometimes, especially with the babies born extrememly prematurely, there is still a fussiness about the baby including a poor ability to calm down once upset. Typically, we expect a baby to become organized when an adult attempts to calm them such as picking them up and/or rocking them, feeding them, repositioning, etc. The following link suggests that many babies with colic later become diagnosed with sensory processing problems. I tend to agree. I see this pattern often since I work with children under the ages of 3 years old.

Do colicky babies have sensory processing problems? | Family Anatomy

My personal experience with my son's fussiness was resolved with multiple reflux medications as well as eliminating from my diet the foods he was found to be allergic to that he was consuming through my breastmilk. So, by no means do I think every child with fussy behavior will one day have sensory processing problems. Yet, I do think fussiness that can't be explained by other things may lead to a later diagnosis of SPD. For more information on sensory processing in infants, visit:

http://www.sense-ablebaby.com

This link provides strategies on calming a baby. It also gives descriptions of why a baby could be crying which better helps a parent to read the infant's signals allowing the parent to have more accurate attempts in calming the baby. Sometimes for a baby who over-responds to sensory input it might be taking away toys, whereas sometimes our instinct is to shake a rattle to give the baby a distraction. But this can make it worse, which in turn causes the baby to become more upset.

Melatonin and Sleep | National Sleep Foundation - Information on Sleep Health and Safety

2010-05-31T07:01:00.000-07:00

I get asked very often for suggestions on children's sleep problems. We go down the basic suggestions such as keeping a consistent bedtime routine, not too much gross-motor activity 30-60 minutes before bedtime, keeping the noise down in the home, eliminating caffeine from the diet, putting away electronic devices 30 minutes before bedtime, and staying away from anxiety-inducing activities (e.g. if the child hates his hairwashed then do it earlier in the day not prior to bedtime). And then we start to analyze that particular child's possible problems related to sleep. For example, a child with cerebral palsy may need to be stretched and massaged so that his muscles can relax, whereas a child with an autism spectrum disorder may need lots of pillows confining the child in the bed along with a heavy quilt and "white noise" playing in the background for that additional calming sensory input. Sometimes those ideas work, and other times they don't. Although I have not ever personally used melatonin as a supplement for sleep, many of the families I work with have used it. Most of them have success and the child sleeps better. Some do not have success. Check out this article at the link below to to see if it might be of assistance to you or your child.

Melatonin and Sleep | National Sleep Foundation - Information on Sleep Health and Safety

As I type this half of my family is still asleep and it is 9 a.m. But I'm letting them sleep in since it is a holiday- Memorial Day! Thank you to all of the veterans who have fought for freedom for all of us in the USA!

Assistive Technology for Children Who Have Cerebral Palsy: Augmentation Communication Devices

2010-05-27T18:43:00.000-07:00

Lately I have helped quite a few families with purchasing different types of assistive technology (AT) devices. AT is technology that aids people with disabilities in performing functional activities that are difficult or impossible unless adapted. This might include adapted eating supplies, special computer keyboards, adapted toys, or equipment for blind or deaf persons. The following link discusses augementative communication (AAC) devices, which is a computerized output system that helps the person talk. I have seen children as young as 2 years old use an AAC device. Depending upon the child's level of cognition and motion in hands, the pre-AAC devices (e.g. Big Mac or Jelly Bean switch) that control battery-operated toys can be used beginning at around 12-18 months of age.

Assistive Technology for Children Who Have Cerebral Palsy: Augmentation Communication Devices

Responding to Toddlers Who Bite

2010-05-26T18:13:00.000-07:00

About 9 months ago, my 23-month old son began biting his sister when he became frustrated. Then, once he became more verbal the unwelcomed behavior faded away. Also, when I was able to figure out why he was mad, I would label what he was thinking, and that reduced the biting. So, if his older sister was playing with a toy he wanted, and I saw "that look" on his face, then I said "my turn" as I helped him point to himself and then had her share with him. So, in my son's situation the biting was due to him lacking the language skills to express what he wanted to say. Many of the kids I work with for therapy bite for the same reason, but others bite for other reasons. Here is a link to Zero to Three's website providing information on toddler biting and how to redirect it:

Zero To Three: Chew on This: Responding to Toddlers Who Bite

Out of the blue the behavior popped back into our lives again. Just yesterday, my son tried to bite my arm. This time it wasn't due to lacking language skills, it was because he was mad at me. He was playing at his train table, and I said "Let's go bye-bye". He didn't want to go, so I picked him up whereas usually he walks over to the door, and then that was when he attempted to bite me. But I caught him in time, and turned his face away from my arm. I then labeled his feelings and said "You are sad that we are leaving. Bye-bye trains and cars." He waved goodbye to his toys and then was happy again. My son is usually a happy-go-lucky toddler, but those "terrible two's" take over from time to time. But the nice thing he is usually redirectable or distracted easily. Us Moms and Dads have to be one step ahead of our little toddlers to help diminish those unwanted behaviors!

The Zero to Three link I provided above is not geared at children with developmentally delays or special needs, but I think the information still applies. Yet I also think there are other reasons for biting and undesirable behaviors with special needs kids including side effects to medication, seizures, and pain (from gastrointestinal discomfort, headaches, or other medical problems). Additionally, many of these children have multiple developmental delays which means a simple task such as completing a formboard puzzle or playing at the park takes more effort than it does for a typically developing child. By the end of the day, these young children are exhausted and it doesn't take much for a tantrum or "meltdown" to occur.
If your child receives occupational, physical, or speech therapy, be sure to discuss the undesirable behaviors and see if they have any suggestions.

Kid's Recipes | 10 Edible Play Dough Crafts for Busy Little Kids

2010-05-21T05:40:00.000-07:00

Having fun with food is so important for a young child's development! Many picky eaters could expand their food choices just by having a different mindset. How better than to make edible play dough! Lots of fun is to be had with edible play dough, and then to top it off, everyone gets to eat it when they are through playing!

Kid's Recipes | 10 Edible Play Dough Crafts for Busy Little Kids

Be careful with some of the ingredients such as peanut butter since some young children have food allergies. Some kids don't have to actually eat it for an allergic reaction to occur, some only have to smell or touch it!

Improving a Toddler's Balance & Vestibular Processing Skills During Play

2010-05-19T05:53:00.000-07:00

My 23-month old son is like most toddlers, he's busy and likes to climb. If I leave the room and return a few minutes later, I am likely to find him standing on a chair or behind the couch. Yet, even though he loves to be in motion, he sometimes still falls. The good thing is, he doesn't fall as often as he did when he had just learned to walk. But, somehow he gets "bobos" on his forehead at least once a month.

Many parents ask me "How do you help a toddler's balance skills?". Well, first of all, know that most toddlers still fall from time to time, but if a child is falling excessively then discuss this with the pediatrician. If that doctor feels that the toddler is falling excessively, then maybe a physical therapy (PT) evaluation will be suggested. PT can look at to see if there are any possible problems orthopedically, neurologically, developmentally, or with the child's level of strength. If these problems have been ruled out, then the child's sensory processing skills should be evaluated, in particular the vestibular system. This can be done by either a PT or occupational therapist (OT), depending upon the therapist's training. The vestibular system has receptors in the inner ear that detect which direction the head (and body) is moving. The possibilities for directions of movement include: up-down, front-to-back, side-to-side, upside down, and in circles. If a child has difficulties processing vestibular input, it may be because he over-reacts, under-reacts, or overly craves the input. Examples of overly reacting would be the child not wanting to be tossed in the air or being scared of swinging. An example of under-reacting, would be a child who seems lethargic and needs extra time running or jum[ing to detect that he is moving. In comparison, a child who overly craves vestibular input can be described as the "Energizer Bunny", and doesn't seem to tire of the motion. Although toddlers should like to move around some, eventually they should move onto to a sit down activity such as rolling cars, feeding a doll, or stacking blocks. A toddler who overly craves vestibular input, may not be able to focus while staying seated more than 20 seconds. Vestibular problems may also be because the child has poor: postural control, the ability to discriminate the input, or an ability to motor plan his actions. An additional problem could be visual processing and/or a poor ability to see far or near; if this is the case, the chid should be evaluated by an eye doctor. For more on understanding sensory processing problems in toddlers or older children visit: www.spdnetwork.org and www.sensorysmarts.com and for more on understanding sensory processing problems in babies visit: www.sense-ablebaby.com

Also, I wanted to share this article that I wrote almost 9 months ago on an informational site. I purposefully simplified the description of vestibular input so that the average person could understand it. It gives ideas on how to help with balance and vestibular processing for toddlers:

How to Improve a Toddler's Balance & Vestibular Processing Skills During Play | eHow.com

I purposefully kept the list of activities simple and short, and suggestions are things that can be done anywhere not just in a therapy clinic. Feel free to comment on any fun ideas you have found that help to develop balance and stimulate the vestibular system. The more ideas, the better!

Child product recalls | Child safety recalls | Latest recalls | BabyCenter

2010-05-14T06:30:00.000-07:00

When it comes to recalls on toys and baby items, many of the things we have in our home have been on the list. My daughter's crib was recalled, so we got a replacement. We then used that crib for my son. I wouldn't have known that crib was recalled too had I not called the company looking for a replacement part for a broken piece on the drop rail. So, once again I was lucky enough to get reimbursed my few hundred dollars and went to purchase another crib. So far so good on this one, probably because there isn't a drop rail! I find it so hard to keep up with all of the recalled products these days, so I'm glad that this link lists them all:

Child product recalls | Child safety recalls | Latest recalls | BabyCenter

Hope you don't have too many of the recalled items!

Why is My Baby Crying?

2010-05-13T16:06:00.000-07:00

Most pregnant women dream about their baby and what that baby may sound like when crying. I watched TLC's "Baby Story" many times while on bedrest with my now 6 year old daughter. She was delivered a little earlier than expected, and was only 5 lbs. and 2 oz. And small babies' cries do not sound the same as full-term or bigger babies' cries. My daughter sounded more like a farm animal than a human! When the nurses opened the nursery door, I could identify my daughter's cries from the other babies' cries...that's because she was the only one that sounded like a little lamb! No kidding!

New parents often have a hard time knowing why the baby is crying. Many assume the baby is hungry, but feeding a baby every time he cries isn't a good idea, especially if the baby has a tummy ache. So, it is nice to learn what the different cries sound like and what they mean. This link discusses the various cries:

Alertness & Crying

When a baby's cries all sound the same, it can indicate a variety of problems including communication, neurological, structural (airway, abdominal, etc.) and cognitive delays. But sometimes once we learn to decipher the various cries and what they indicate, we notice the baby does have various cries. Maybe he has one for when he's hungry and another one for when he has pain (tummy ache, fever, etc.), and maybe even another cry for when he's bored. But when this isn't the case, it is definately something to discuss with the child's pediatrician.

When It's More Than Just A Cleft Lip and Palate

2010-05-10T16:47:00.001-07:00

One of my childhood friends had a baby a few years ago that was born with a complete cleft lip and palate (unilateral). Luckily, after several surgeries and speech therapy, the young boy caught up with his development. But some families are not as lucky. Sometimes there are more things going on with the child. Often, these things are obvious such as heart or kidney defects, genetic syndromes, or neurological impairments. Other times, the problems are mild so it takes longer to get noticed; even the ones that are genetically linked. I'm not sure if the pediatrician doesn't refer the children for genetic testing or if the family doesn't find it necessary to meet with a geneticist.

Since cleft lips and palates may occur due to a neural tube defect that takes place during the first trimester of pregnancy, other parts of the body- especially in the mid-line may have not been formed properly either. Somethings I often see in children with cleft lips and palates include dysgenesis of the corpus callosum, global hypotonia, poor crossing of midline, swallowing problems (esophageal), and strabismus (eyes turning in). These children luckily get referred for occupational therapy (OT) and/or physical therapy (PT) in addition to speech therapy. The ones who do not get referred right away are often the ones with mild hypotonia and incoordination on both sides of their body; maybe they are just a little behind with their fine-motor and gross-motor skills as a toddler or preschooler. If this is not addressed, these children approach school with a disadvantage and all of the sudden a mild delay that is not addressed becomes a significant delay. This is when it is helpful to have a speech therapist (SLP) who knows alot about motor skills so that they can properly refer to PT and OT. If you are a parent or SLP who is wondering when it is appropriate to refer to PT/OT, then consider the following:

- Can your child keep up with his/her peers at birthday parties, playgrounds, or other group situations? Does the child fatigue easily?

- Can he/she jump by age 2 1/2? Ride a tricycle by 3 y/o? Do jumping jacks by kindergarten?

-Can the child play in a variety of postures: on the belly in the floor, in side-sit, ring-sit or criss-cross, long-sit, or kneeling?

- Does the child have a hand dominance by preschool age? even when there is a dominance the child should be able to use both arms and legs as well as cross the middle of the body. Does the child ignore one of his hands or efficiently use 2 hands such as to throw a ball and manipulate interlocking blocks? Does the child rotate his body in the chair to avoid crossing the midline of the body?

-Can the child feed himself with utensils age-appropriately? hold a cup?

-Is the child's pre-writing or handwriting skills delayed or sloppy?

If the answers warrant concern, then it is suggested that your child receive a PT and/or OT evaluation. After the evaluations, the therapists can discuss if therapy intervention or home exercise program are needed.

Ideas For Developing Coordination On Both Sides Of The Body

2010-05-01T09:45:00.000-07:00

I often work with little kids who have cerebral palsy (hemiplegia, diplegia), peripheral nerve injuries, a stroke, or for whatever reason are stronger on one side of their body than the other. Below are some ideas for encouraging them to use both hands and/or feet:

1. Ribbon Dancers: long wands with ribbons on them. You can have the child carry one in each hand while you do the same, and then move the wands around imitating each other.

2. Zoom Ball: a ball that slides along two parallel strings with handle bars at each end. This activity takes two people, but is SO fun, because as one person closes their arms to catch the ball, the other has to open their arms to send the ball to the other side.

3. Rolling pin to roll out play-dough or cookie dough, then use cookie cutters

4. Mr. Potato Head: one hand is used to hold Mr. Potato while the other is used to insert the pieces

5. Imitating animals: bear crawl, dog, donkey kicks, slither like a snake

6. Scooter board: child lies on his tummy and propels self with both arms

7. Step in paint and walk across butcher paper to do feet art; could also do this with water out on the sidewalk, but of course this artwork will dry up from the sun

8. Obstacle course: climb up, crawl over or through things, jump forward or backward

9. Pushing objects such as large boxes or containers, laundry baskets, strollers

10. Bicycle

11. Yoga: kids yoga books and DVDs are usually easy to follow along

12. Songs with motions of the arms and legs: If You Are Happy & You Know It, Wheels on the Bus, Twinkle Little Star, Little Bunny FuFu

13. Roll cars with one in each hand. The cars that are to be shaken first are fun

There are so many more things that can be done to encourage using both arms and legs. Use your imagnination and you will be able to come up with so many more! Also, ask your child's physical and occupational therapist to give you some exercises and games to work on in between therapy sessions.

Symptoms of Tongue-Tied (Short Frenulum, Ankyloglossia)

2010-04-22T18:08:00.001-07:00

Recently I had a friend whose baby was diagnosed with being tongue-tied, also known as ankyloglossia and short frenulum. I wish that her baby boy had been diagnosed sooner, but it took over a month. Although that seems long to me since I work with small babies, I know that some people go even longer before having an answer to their child's feeding and language problems.

My friend's son had poor feeding problems from the beginning and didn't learn how to breastfeed. That should have been the first clue of a problem, because Mom had already successfully breastfed her older son for a year. She said when she attempted to breastfeed him, it hurt really bad, even after she tried to put his lips on the right part of her areola. I only wish she could have gotten together with a lactation consultant (LC) because I think it would have been diagnosed then, but she didn't go to a LC. So, Mom switched her son to a bottle, but not just one bottle, she went through 5 different types of bottles and nipples before she found the "right" one. Even then, he only drank an ounce or two of formula at a time and it took over 20 minutes just for that small amount. He had poor suction on the nipple of his bottle and pacifiers, which lets us know his tongue wasn't working very efficiently. Somehow he was slowly gaining weight and not losing, yet the quality of life was chaotic for Mom because she was practically feeding him most of his waking hours.

After talking to her sister-in-law over the phone who lived far away, but who happens to be a pediatric nurse, my friend realized what it was- ankyloglossia. She was asked to look to see if he could stick his tongue out over the gumline, and he couldn't. She was asked if the tip of his tongue looks like the bottom of a heart because of the skin under the tongue bounding the tongue down, and guess what, it did have a heart shape. My friend was advised to take this information back to her pediatrician, so she did. Once the doctor got a better look, she realized that other symptoms were present. They included: high palate, gags easily, and sometimes has trouble swallowing liquid (would just hold it in the oral cavity). Also noted was that he had tight neck muscles, maybe because he was using every head/neck muscle he had just to drink from a bottle. My friend's son was also diagnosed with GERD (reflux), so I think that the feeding problems were blamed on that, but once the medicine didn't fix everything, it was obvious there was more going on than reflux.
He then got his frenulum (skin under the tongue) clipped. Feeding problems got immediately better, and he has gained weight at a higher rate now. He doesn't even need to do any oral-motor exercises, he just figured it out after a couple of feedings, and he can even drink from more than one type of bottle. So, not only were mealtime problems resolved so were any possible future speech problems! And even better, parents can sleep more at night with less frequent wakings for a feeding!

Every once in a while, I am the one that notices ankyloglossia, but usually it has been identified by the hospital staff, pediatrician, or lactation consultant long before the child was sent to me for a feeding disorder. Sometimes when I catch it, there are other problems as well including delayed gross-motor skills, poor sleeping, and irritability...of course if I couldn't eat and sleep well, I would be grumpy too! So, don't assume that just because no one has ever diagnosed your baby with being tongue-tied that he doesn't have it. If you notice the above-mentioned symptoms, please call your child's physician and have them do a detailed oral exam!

Improving Balance Through Simple Play

2010-04-18T13:36:00.000-07:00

I used to work in a therapy clinic and before that a hospital. One of the positives to those facilities, was LOTS of equipment including swings, rocker boards, balance beams, balls of various sizes, rock walls, air mattresses, trampolines, and more! It is so much easier to help children work on their balance with all of this equipment. The downside is that the child doesn't have this equipment at home, and at the most the child is getting 1-3 hours of weekly therapy in the clinic. So, what about all of those waking hours spent in play at home with no equipment? How can the family help the child improve on his balance skills? Well, going to the park, restaurant playgrounds, and mall play areas are great ideas, but those locations are limited also...you can't live there after all. You also can't live at the facilities that have gymnastics, dance, and karate lessons.

I like to teach parents simple ways to help a child improve his balance skills that doesn't require any equipment at all; just their bodies and items they already have around the home. Some simple ideas for babies and young toddlers include:

-Lap play: have the child sit on your lap while facing you, and as you sing and talk to him, bounce him gently up/down and side-to-side to help elicit equilibrium reactions in which the arms come out to the side and the head comes back to the middle. I sing songs such as "The Noble Duke of York", "Rock, Rock, Rock Your Boat", "Getty Up Horsie", and make up songs that don't even exist. Initially, place your hands on the child's trunk (belly/back), then as he improves, lower your hands toward his hips. Be sure to watch the facial reactions in order to know if you can make it harder or should slow down.

-Animal walks: toddlers love to play pretend such as getting on all fours on the floor and pretending to be a cow or puppy. They also like to slither on their bellies as if they were a snake. My two favorite animal imitations are donkey kicks (get on all fours and kick the legs behing you) and bear crawl (similar to a dog, but straighten the legs so that the bottom is pointed in the air, if you are into Yoga it is the "Downward. Dog" pose). Try these or make up some animal imitations.

-Dance: Hold the older baby or toddler in your arms while you sway side-to-side, spin both ways, or jump up and down. Even lean over to see if the child can handle his head being upside down.

-Jumping on the bed: hold the child if he can't jump yet and help him jump. Then after awhile, place him on the floor and see if he can stand longer on his own. Often, the proprioceptive input from jumping helps with "body in space" awareness". If the child can independently stand and jump, then make the game harder such as squatting to jump like a frog or bunny, or add singing or music, especially a song about jumping. For an older toddler, have them jump down from a stool or over the stool as if they are Jack Be Nimble jumping of the candlestick!

I have many more ideas...the sky is the limit! I just listed a few to let you know that you don't need lots of expensive equipment to work on balance skills in between therapy visits. Well, time to go join my husband and daughter playing "Five Little Monkeys Jumping On the Bed".

Fostering A Young Child's Imagination

2010-04-10T15:14:00.000-07:00

I have to hand it to my husband because for someone without any education what so ever in child development, he does an excellent job of fostering our two children's imagination. It is not uncommon for him to bring home toys or items for him and the kids to play with. He tends to buy the fun imaginative toys and I tend to buy the fun craft projects and gross-motor toys; my only rule is no hand-held electronic devices until the kids are older. I also limit computer time and electronic toys of any type. The key word is limit, not eliminate.

My favorite story about him and my daughter playing imaginatevely is how he bought her a Peter Pan costume and him a Captain Hook outfit that included the eye patch, hat, hooked hand, and sword. He did this back when she was four years old and they had watched the Disney (R) Peter Pan movie numerous times. She then started wanting to act out scenes with her Dad. Of course he is thinking "How can you really act out the scenes without the proper gear?". I stood back and watched them play. It was amazing to watch. She quoted lines from the movie here and there, but mostly just played the part. He would toss her in the air onto our king-sized bed to pretend like she was shot out of the cannon. Then she walked across the bed as if it were the plank. They also had sword fights with foam swords. She sometimes switched roles and was Tiger Lily. To top it off, she insisted at bedtime everynight for at least 3 months that him or I read the Peter Pan story to her. From an occupational therapist's point of view it was nice to see the motor planning, coordination, and problem-solving during the whole play period.

Really, this is huge, because so often the children I work with that have developmental disabilities have difficulties with play. Not only is the reciprocal interaction difficult, but also not perseverating on how things must go. Often the play skills of the kids I work with is initially guided by the adults. It then hopefully progresses to the children initiating the ideas and expanding the amount of time they can play one activity. Because I work with infants and toddlers I don't see this often, but sometimes right around the time the child turns 3 years old it starts to emerge. It is times like that I wish I still worked with children of all ages such as when I worked in a therapy clinic.

Sometimes I work with children who are functioning age-appropriate or above normal in the area of cognition. Maybe I am working with them in OT due to feeding problems or orthopedic impairments of the upper extremities such as a brachial plexus injury. When I do work with these kids, once they are two years old I can get them to do amazing things all in the name of imagination. For example, if I can get a 30-month old boy with a nerve injury to his arm to pretend that the exercise ball is a horse and that he is a cowboy, then I can get him to do some great stretches, strengthening, and balance exercises without him ever realizing it. If his favorite character is Spider Man, then we can jump, wheelbarrow walk, and go through obstacle courses while he pretends to be Spider Man. The possibilities are endless.

One population of children with age-appropriate cognition that I sometimes see a "not so good" imagination in is kids with feeding problems. Not the mechanical or motor problem feeding delays, but the behavioral and sensory-based feeding problems. Some of the time this is due to the overly structured environment they live in along with being constantly told what to do; maybe this is the etiology of the feeding problem- they can control food and mealtime even when they can control nothing else. Before I make anyone mad, I emphasize "sometimes", mainly because sensory-based feeding problems have many reasons for arising. I am focusing in on when it is truly a child with behavioral based feeding issues. For example, if a 2.5 year old child is somewhat robotic in that he can label colors, animal names, and facts that only a 5 or 6 year old would know, but can't play with his kitchen play set or with another child interactively, then imaginative play is delayed. And the reason is not because he is not intelligent enough. I can peg these kids quite early on in the evaluation process because usually the parents are trying to answers questions for the kid and guiding them to follow my directions with multiple cues. If the child doesn't perform, the parent either becomes frustrated, demands the child do it again, or tells me "I know he can do this".

Some thoughts on promoting imagination during play:

- offer toys that can be played with in more than one way such as cars, blocks, dress up clothes, and balls. Not that toys that can only be played with one way are bad, they just may not promote the imagination as much.

- follow your child's lead instead of having them join your play all of the time. For example, if your child has a limited repertoire of play and insists on playing with trains on the tracks, not expect him to play dress-up with an animal costume. Instead, change the train tracks, change the location of the train table, or push the trains around the room including over the chairs, under the table, and through the hallways while making "choo-choo" sounds. Expand upon their interests which is much more likely to help them be creative.

- encourage simple artwork such as finger paints, water sticks, chalk, and crayons. Do this with blank paper as opposed to a coloring book

- set up obstacle courses and pretend like you are in the jungle or some other place, and name all of the furniture after what you would see in the jungle. When crawling between the back of two chairs with a sheet draped over it, pretend as if that is the dangling greenery from the jungle trees.

Well, that is enough ideas for now. I am off to go play cops and robbers in the backyard with my two little ones!

Understanding Social Cues

2010-04-04T18:24:00.000-07:00

Today is Easter. Yesterday, our subdivision had an Easter party and mini-carnival in the nieghborhood park. Not only do I love these type of events because they are fun, but I enjoy watching children play. I think it is fun to watch the kids during the Easter egg hunt. And this year a little excitement was added when a baby rabbit jumped across the park, then 10 minutes later the mama rabbit jumped out too. The kids were squealing ecstaticly as they watched and chased the rabbit. Of course the kids were also happy to participate in the games such as the bean bag toss, "fishing", sack races, and the cake walk.

It was at the cake walk that I was in such a state of analyzation while I observed my son. At first, he was watching the other kids (including big sister) walk around the course of numbers as he sat in his stroller. Then they stopped and if their number was called out, they won a cake or other treats. Eventually, he repeatedly said "walk, walk", so I let him out of the stroller. My gut was that this 21 month old is going to run all around aimlessly. But he didn't. I was pleasantly surprised when he went over and joined the school-aged children at the cake walk. He even went the correct direction and walked about the same distance from the numbered markers as the other kids. What impressed me the most, is when the music stopped he looked around and noticed the other kids stopped at a marker. So he stopped and he stood there for about 2-3 minutes just like the others did. When the music began again, he participated again. I was in such awe that I didn't have to teach him how to participate; he just took social cues and used them correctly. I have 6 year old clients with developmental delays or autism spectrum disorders that don't know how to do this. It always amazes me how effortlessly a typically developing child learns to perform such skills. Maybe because I was an occupational therapist for 9 years before I had my first child, but I am always flabbergasted that such things don't have to be taught. This makes me appreciate the littile kids that I work with even more, because they have to work soooo HARD for every new skill they learn. And for many reasons, social skills are one of the last things to come along. Language and motor skills are often the focus of therapy initially. Later on, emotional, behavioral, and cognitive skills are addressed. But it takes all of these skills combined to have decent social skills. Whether it be reciprocating during conversation, imitating the action of peers, or not blurting out something inappropriate, social skills do not come easy to many young (and older) kids with disabilities.

Sometimes to work on client's social skills, I meet clients and their parents within the community such as at McDonald's (R) playground and parks. These places seem to always have other children present which makes it the perfect location to work on social skills. Sometimes, I have clients that progress to reading the cues of the other kids, but so often we are working on the basics such as waiting in line at the slide, not pushing or hitting other kids, and playing near other children. I do think however with repetition that many children eventually learn these skills, especially when imitation is a focus in individual therapy sessions. Those who do not catch on naturally over time may benefit from a social-motor group at a local therapy or psychology clinic. At first, the parents and therapist are exerting a lot of energy for the kids to play together. Over time, it is nice to see how the adults can back-off because the kids are improving...yeah!

CLASS: community living assistance services and supports

2010-03-26T18:25:00.000-07:00

If it weren't for the recent healthcare reform bill, many Americans would shrug their shoulders if you asked them if they knew what the commnity living assistance services and supports (CLASS) program was. In fact, some of them still don't know what it is, mainly because the healthcare reform bill is over 2300 pages long, so who could expect them to understand every single detail?!? But this post will not get into my positive and/or negative thoughts on the bill. I am just motivated to blog on the CLASS program.

Although it is a federal program that provides long term care for mentally and/or physically disabled Americans, each state varies a bit in how they handle enrollment and other details. Information on the criteria for who qualifies can be found on this government link:
http://www.retiredamericans.org/ht/a/GetDocumentAction/i/12355 and http://www.kff.org/healthreform/upload/7996.pdf

What is consistent across state lines is that it helps with the long term needs of the individual. It may include payment for adapted feeding equipment, respite, physical/occupational therapy treatments, wheelchair and accessories, and modifications to a home/apt. By keeping the individual with special needs as independent as possible, it is believed to help in numerous ways, and possibly save the taxpayers money because the individual is overall healthier and less dependent upon caregivers. I have had the honor of providing therapy services to young adults with cerebral palsy in which CLASS paid for it. The only thing that seemed to be a bit burdensome is when I ordered adapted feeding equipment or computerized assistive technology, it took many months for the paperwork to be processed and items to be purchased. But hey, at least it got paid for eventually, and these young adults wouldn't have had the money to pay for it on their own otherwise.

I presently work as an occupational therapist with infants and toddlers, and at times am doing case management (social work) with families too. One of the things I encourage families with children with developmental disabilities (cerebral palsy, down syndrome, CHARGE, etc) to do is sign up for the CLASS program. They can sign up on the waiting list for more than one company that sponsors it, but once they're application is being processed they can only go with one facility. I say to go with the first place that calls you, or at least in my area. One place I know off of the top of my head that offers the programs is MHMRA. In the state that I live in sometimes it is 5 or more years before the child's application gets processed and they begin the CLASS program. Some states are quicker, probably depends on funds and populations...not sure. It seems so weird to rush these parents of babies into signing up for various programs when they have barely grasped the reality that their baby will have a permanent disability. But if they wait to sign up for it when they need it, then they'll be disappointed of the waiting period. There are numerous other programs that I encourage people to sign up for, but I think every state is so different in what they offer. I encourage parents to find a case manager if they don't already have one. They can really help you navigate the world of special needs programs. And it looks like after the healthcare reform bill is in effect, there will be changes to the present programs as well as new additional ones.

Defying Gravity...Carnivals Should Be Fun!

2010-03-18T22:06:00.001-07:00

Today my family of four along with my sister-in-law went to the carnival. Within the "kiddy" section, there were simple rides like the carousel but there were some more gravity-defying rides as well. My husband enjoyed riding the rides with my 6 year old daughter while my 21-month old son stayed in the stroller and I took pictures of everyone. But I did manage to get on one ride with my daughter, and boy was it fun! It was a ride that went in a circlular pattern while the kids/adults layed two people to an "airplane". While on our airplane, we were lying on our bellies and strapped in from behind. Not only did the ride go in a forward circular pattern, but it also went up/down making you feel as if you were "losing your stomach". Now, I grabbed my little one's hand, because I was thinking she may freak out. But I was wrong, she squealed with laughter. She had so much fun! And she should have. Once kids are of a certain age, they should think it is so much fun to move in various ways against gravity. It is not uncommon to see a toddler trying to be upside down off a couch or jumping off of furniture!

There are five directions to move within space: up/down, forward/backward, circles (rotary and axial), upside down, and sideways. Swinging on a swingset back and forth is a simple way to move, whereas riding the carnival ride today as described above was more complicated because it combined movements. When we move in these various directions, vestibular receptors in the inner ear are stimulated. The vestibular system can be a tricky sense. When a person has an ear infection or vertigo, this system can go haywire and throw the person's balance off. It is quite scary to feel off balance. That is why some kids with vestibular disorders don't like carnival rides. In fact, some would probably whether do anything but get on that ride!

If you have a child who doesn't like to play at the park on the swings, slides, or climbing devices, it is possible that he has difficulties with vestibular processing. If the child also has a gross motor delay or falls often, this should be discussed with the child's physician. Physical or occupational therapy services may be necessary to help the child. It may seem trivial when the child is only 2 years old, but if the problem is not corrected, the child ends up being a grade schooler who can't ride a bike or roller skate with his peers. He may also be the type who is clumsy, making him be the last one chosen to play games during school recess such as for soccer or dodge ball. If you suspect that your child has problems with vestibular processing, it is definately worth checking out.

Some other signs of the problem could include: low muscle tone, delayed development with two handed activities, clingy to parent when should be playing with peers (especially at birthday parties), fatigues easily, scared to sit in chair or on potty due to dangling feet, short attention span, and delayed eye-hand coordination. Those were all symptoms of kids who are over-responsive to vestibular input or who have sensory based motor disorders. Kids who are under-responsive are more lethargic and passive. Kids who are sensory seekers are described as the energizer bunnies and can never seem to get enough movement unless they are asleep. Some of these kids are even known to tire out the family's energetic dog! They tend to jump from high surfaces, fidget, and spin around. All of this over activity needs to be directed, especially if the child has a language or fine-motor delay. These children may or may not have a sensory processing disorder (SPD, AKA sensory integration dysfuncton), but should be checked out by a therapist. I don't think that every child with the above-mentioned symptoms necessarily has a vestibular disorder, there could be other things going on including neurological deficits, other disabilities, or environmental factors. An example of an environmental factor is lack of or decreased stimulation such as being at home all day with a mom who is on bedrest and can't help the child get the necessary exercise he needs, so he overly seeks out movement such as jumping off of high surfaces. This is the case where it is well worth it to pay extra for a young babysitter to come over to play or to invest in a mini-trampoline for the living room. So, not every referral to a therapist will mean the child needs intervention, but maybe at least some ideas can be generated for helping the child.

Understanding Baby's Signals

2010-03-11T16:02:00.000-08:00

By no means am I the baby whisperer, but I'd like to think that I am pretty good at reading cues babies give off to let us know their needs. For example, sucking on their fingers indicates that they are hungry whereas having irregular breathing can indicate they are drowsy. I think that this is important for new parents to understand, especially when it comes to understanding why the baby is crying. Afterall, not every tear shed from the baby means they neeed a bottle!

Instead of re-writing every signal babies tend to give off, I am providing links to a couple of sites that do a good job of explaining this already

http://www.sense-ablebaby.com/Our_Baby.html#Infant_Sleep_&_Wake_States

http://www.uihealthcare.com/depts/maternitycenter/newborninfo/signals.html

Liquid Needs for Children

2010-03-07T07:08:00.000-08:00

In the next room over I hear my toddler son requesting for a "deen". Translation = drink. If I let him, he would graze all day with a cup in his hand...not a good habit to create. Especially since he is at the low end of the chart on weight for his age. And I notice that the days I inadvertently give him too much liquid, he doesn't eat as much. So, I try to stick to liquids at meals and snacks, and other sips here and there.

One thing I get asked alot at work is "How much liquid does my child need?".
Well, that's a great question. If kids are eating lots of fruits and vegetables, then fluid is in those foods as well. So, it's not as simple as saying how many ounces of fluid should be in their cups. It can be a fine line. Don't give the child enough fluids and they get dehydrated...especially in the hot, summer months. Give the child too much fluids and the result is more difficulty with potty training and the child eating less food. This sounds like a trivial issue for some people, but for the kids I work with that have special needs, it can be a complicated topic. Many of them have a diagnosis of "failure to thrive" with the threat of a feeding tube hanging over their heads. In these cases, the parents and caregivers are counting every calorie. Especially for my little ones preparing for heart surgery who are burning calories at a faster rate than typical.

The rule of thumb is: 2-2.5 oz of fluid per pound of body weight is needed for an infant and 1-1.5 oz of fluid per pound of body weight is needed for children. The differences are due to toddlers and older kids eating table food, in which many foods have fluids within them. Examples include apples, soup, tomatoes, etc.

Now this is not always the case. Some of the kiddos that I work with are on high calorie formula and may not take in as many ounces of liquid for various reasons. Also, babies with severe infant reflux may spit out alot of liquid...this can be a fine line too, because if these babies are overfed to make up for the fluid loss, then they will just spit it up again!

Well, there is not a simple answer in terms of how much exactly a child's cup should contain and how many times a day. But, hope this entry helps give a baseline!

Apraxia of Speech

2010-03-04T20:15:00.000-08:00

http://www.apraxia-kids.org/site/apps/nlnet/content3.aspx?c=chKMI0PIIsE&b=699375&content_id={77B3D5EE-D59D-4198-8F68-D4925C00354B}¬oc=1

This article explains that using repetitive books to help with apraxia of speech is beneficial. My two favorite repetitive books are Goodnight Moon & Brown Bear, Brown Bear. Although I am not a speech pathologist, I work with many children with dyspraxia of the body and apraxia of speech. I definately think repetition and predictability help these children to gain new skills.

My daughter loved her "Goodnight Moon" book so much, that we wore two of them out, and I had to buy a third. Through repetition of reading it to her, and her looking at the pages often, she pointed out to me that the mouse is in a different location on each page. Pretty good of her to have noticed that at the age of 2 years. But I'm sure that if I had not read that book over and over to her, she probably wouldn't have noticed it!

Simple Strategies to Help with Plagiocephaly

2010-02-26T15:25:00.000-08:00

Plagiocephaly is a fancy word for mis-shapen head. It can happen for many different reasons in a small infant, especially since their heads are malleable and change shape easily.

My now 20 month old son had a slighly flat spot on the back of his head because he was positioned upright and reclined which put pressure on his head. We had to position him like that due to his severe reflux. I think the flat spot would have been worse had I not put him in "tummy time" so much of his waking hours. Of course, I couldn't lay him in this position until at least 45-60 minutes after a feeding or he would vomit. Once he got around 5-6 months of age, he would roll over and sleep on his tummy. By 7 months he was crawling. These things in addition to all of the reflux medications he was on contributed to a better head shape by 8-9 months of age. His head shape was never severe enough for a helmet. But I explained his situation to indicate how easy it is for a child's head to get mis-shapen and back to being okay.

Often, a baby with torticollis or neurological damage is prone to plagiocephaly. Also, babies with medical problems who aren't able to move age-appropriately, such as preemies, those with heart defects, and babies who have had multiple surgeries. Another reason can be being a multiple (twins, triplets, or more) or a large baby born to a petite mom; this is because there isn't as much wiggle room and they may get stuck with the neck and head in an awkward position.

If your child has been diagnosed with plagiocephaly then hopefully he/she is getting occupational and/or physical therapy services. Therapy can help with neck/trunk strength, stretches, and massage as well as helping with any necessary adaptive equipment to help reposition the baby.

Some simple strategies to help when the head is mis-shapen on the left or right side:

-switch the way the baby is carried, sometimes over the left shoulder and sometimes over the right

-switch the way the baby is held when being fed, sometimes on your right side, other times to your left side

-when using a changing table for diapering, alternate which end the baby's head is at, this helps the baby to look in different directions

-move positioning equipment within the room: bouncy seat, bouncers, swings, etc. so that the view is not always the same for the baby

-when approaching the baby as he/she is in a device or on the floor on a blanket, come from different directions to help the baby look to each side as well as overhead and to the front

-don't sit the child in a Bumbo (R) seat or standing bouncer before he/she has the trunk control to be in it. This is also the case with Jumparoos (R) and Johnny Jump Ups (R). If the baby doesn't have enough trunk or head control, then he will lean to the side which only perpetuates the asymmetry of the head

-offer the baby toys to each side of him wherever he is: swing, floor overhead gym, carseat, on tummy on blanket on floor, etc.

-get down on the floor and play with the baby, sometimes be on his right side, other times on the left or to the front

-infant massage indirectly initially such as to the belly or legs, and then if tolerated to the chest, neck, and arms

-follow through with all exercises/stretches given by the PT and/or OT. Be careful about getting aggressive stretches off of the internet, because depending upon the etiology of the plagiocephaly these stretches could be hurting the baby

Final thought: if your child's doctor prescribes a helmet to help with head shape, then by all means get a helmet and use it the suggested wearing schedule (usually 23 hrs a day). I have seen some amazing changes in head shapes of babies with helmets.

To see pictures of plagiocephaly and helmets, visit www.cranialtech.com

Helping Young Kids Speak Through Singing

2010-02-19T20:29:00.000-08:00

My family has a joke that none of us can stay on tune while singing, but oh well, we still like to sing. But I have to admit, I don't sing as loud at church as I do in my car, because I don't really want people looking around and thinking "Who is that really off key singer?". Not that others would judge, I just play it safe.

My two kids and many of the infant/toddler clients I work with (in occupational therapy) enjoy singing. I actually don't mind singing loud around small children, especially since they don't expect me to be as good as if I were auditioning for American Idol! In fact, many kids I work with start to say simple words from a song before they speak to express their needs and desires. Singing is what "gets the ball rolling".

My son is now 20 months old and is speaking quite a bit. He has at least 50 spontaneous words and others that he will repeat when asked. But I think back to before his first birthday, and he loved for me to sing "Itsy Bitsy Spider". As he got older, he tried to imitate the hand motions and sing a word or two. But before he was saying some of the words, he would stop and really listen. Other times he would dance or sway and even try to hum. This let me know he was really into the singing. One technique I used with my son (and some clients) is sticking to just two or three of the same songs/verses and repeating them often. Then, I would intermittently pause to see if he would gesture me to sing more or even better yet to see if he would try to say the next word as if he was "filling in the blank". This is one of those techniques that takes a bit of patience, because it can be mundane to an adult to sing the same song day in and out. But small children need that, that is how they learn. When choosing a song, choose one with a simple repetitive rhythm such as "Twinkle Little Star" or "Wheels on the Bus". These two are also nice songs to teach because they have hand motions to go along, and some children may start by imitating the body action before saying a word. And that's okay, at least it is some sort of participation that lets you know they are absorbing the cognitive component of a song.

So often when a child has a speech and language delay, the family and caregivers can hardly wait for the child to start expressing his needs. I don't blame them, it can be frustrating when a tot throws a tantrum because you have no idea what he wants. For some kids, using some basic strategies to get them to talk works, and before you know it, they are letting you know they are hungry or want to go outside. But for other kids, strategies have to be a bit more sneaky and fun. Well, what can be more fun than singing and playing while doing it! I love to use "Ring Around the Rosie" with older toddlers because they love to run and "crash" onto the floor. One thing I do is to just sing it normal for 1-2 rounds, and then after that I don't crash or have them crash to the floor until they say "down" during the last part of the song that goes "we all fall down!" For a child with a severe speech delay, they may only grunt for the word down and for a child with Autism Spectrum Disorder they may simply give me a glance, but it is a start. A glance is a form of communication that can be shaped eventually into words or higher forms of communication...and to think, something as simple as a song can be that powerful!

Some days at work I feel like I have sang the same song WAY too many times. Other days I am so glad to be singing those wonderful toddler tunes. Maybe that is why I am guilty of listening to toddler CDs in my car even when the children have been dropped off at school and the babysitter's home! The slightly funny thing is that I have more of my children's music CDs in my car than I do of my own! At least my iPod has absolutely no toddler tunes...that might be kind of taking it too far if I did!

The Most Common Infant Disablities and How to Recognize Them

2010-02-19T20:25:00.000-08:00

The Most Common Infant Disablities and How to Recognize Them

The Drive-Thru Carwash, What's Not To Like?

2010-02-13T14:39:00.000-08:00

My two children love to go through the car wash after I fill up my car tank with gas. What's not to like about the drive-thru car wash anyways? The car gets sprayed with water, soaped up, and "blow dried" before you leave the tunnel. Well, it is quite the sensory rich experience, because the car is moving while all of these noisy machines are coming at you!

Although my typically developing kids think it is fun, I can see why a child with sensory over-responsiveness, poor motor planning (AKA dyspraxia), and/or anxiety would not think it is fun. If lots of noise, sights, movement, and smells tend to be over-whelming to a child, then the car wash is not the place to go for entertainment!

This gets me thinking, how many common daily or week events would be over-whelming to these children. Well, just to name a few: going to the grocery store, taking a bath including washing hair, mealtime (preparation and eating), singing at church, going to the local park, and playing with other children. Then, there's always the events that tend to happen on a monthly or quarterly basis: birthday or holiday parties, haircuts, zoo, and going to the movie theater. How fun would life be, if these things created more anxiety?

Children who over-respond to sensory input to the point where it interferes with functioning in life events, could benefit from occupational therapy services. Children who have difficulties with motor planning and learning new activities or with transitions could often benefit from occupational therapy as well; these kids tend to be clumsy and may need physical therapy, and may also have a speech delay requiring speech therapy.

One thing that is beneficial to do at home for these children is to make routines predictable. This helps them to feel in control because they know the order of events. But we all know that the unexpected can happen, so the best thing to do is be calm and provide calming sensory input (see www.sense-ablebaby.com ). Realize that the child gets upset and reacts the way he does because of the "fight, flight, or fright" response. If attending occupational therapy treatment, ask the therapist for a home program and ideas on how to handle tough situations. This is especially the case if the child has been diagnosed with sensory processing disorder (AKA sensory integration dysfunction).

Well, I'm off to go cook a new recipe- not a predictable experience. And I'm doing this after I attended a sporting event, took my child to a roller rink with her friend, and cleaned up my son's vomit...none of which are predictable experiences! Wow, and it's not even 5 pm yet!

Helping Babies With Reflux

2010-02-08T19:38:00.000-08:00

I spend a lot of time at work helping premature or developmentally disabled infants with feeding problems. I have also become a resource for many of my friends with babies who either are known to have reflux or are having feeding or weight gaining issues. One website I have found helpful is:

http://www.coliccalm.com/baby_infant_newborn_articles/acid-reflux.htm

I also like the book Colic Solved by B. Vartabedian, M.D., a pediatric GI doctor who talks about reflux and "colic"

My son had reflux problems even after he was one years of age. Many kids improve with spitting up once they have started solid foods, but some do not. I have previously blogged on how my son had problems gaining weight and was somewhat fussy due to the spitting up episodes; we called him "Milkshake"! Thank goodness for the medicines, positioning, burp cloths, and time!

Remember that a baby doesn't have to necessarily spit up massive amounts to be diagnosed with reflux (GERD). Wet burps, hiccups, congestion, tummy aches/gas, and fussiness can be symptoms too. Overall my son was a "Happy Spitter", but sometimes the acids of the spit-up really hurt his throat and he became fussy. Thank goodness for Prevacid (R)! The Zantac (R) was helpful earlier on, but then not so much later on. But every baby is different. He also took a medicine for motility to speed up the digestion process; this may be needed if the baby is spitting up even 2 hours after a bottle/ breastfeeding.

A big pet peave of mine is when parents don't continue to give their baby the prescribed reflux meds! Maybe they do this because the baby is gaining weight or they didn't think it was helping, or maybe the baby spits up less. But "Hey" maybe the child got better because he had been taking the medicine! But any wet burp is going to irritate the throat, that is why so many of these kids guzzle down a bottle or pull away and don't want to drink. It is also the reason they don't sit up well because they are arching back in pain. Remember to discuss discontinuation of meds with the doctor! Maybe something else could work better or a different dose or giving it at a different time of day. The doctor probably has plenty of swell ideas, but he/she needs to know!

Now I am stepping off of my soapbox and thankful that we haven't needed any burp cloths in my house for the autumn and winter months...yeah! I am passing them along to a dear friend of mine who has a young infant who spits up often! Remember: Spit Happens

Sense-Able Baby Website

2010-02-08T19:33:00.000-08:00

Home Page

Great resource on sensory processing problems in infants. Also provides ideas on calming babies, understanding why they are crying, and body signals they give off to let you know when they are hungry, sleepy, or ready to play. Great links page on a variety of resources for babies who are typically developing and special needs.

Alternative Dairy Beverages

2010-02-07T18:26:00.000-08:00

I have blogged before on my two children's food allergies. I could probably write a handbook and cook book on the subject. I remember when my daughter was a small baby and would have allergic reactions such as hives and rashes. Her reactions were from various foods she was allergic to that I had eaten, that were then passed on through my breast milk. Initially, I found it very difficult to alter my diet since I could only eat foods she was not allergic to. Stressed out doesn't even begin to describe how I felt at the time!

Since then, I have learned to cook and buy products that do not have the foods my kids can't have (dairy, eggs, red food dye, nuts; was also soy, oats, citrus). Here are some alternative dairy beverages and reasons they may be used over the other choices:

-soy beverage: good alternative especially for cooking, but many kids are also allergic to soy.

-rice beverage: tastes like skin milk, but low in fat; not the best alternative for a toddler needing to gain weight.

-almond beverage: great taste, but many kids are also allergic to nuts, and those who aren't are likely to grow into the allergy with continual exposure to almond milk. Unfortunately, this was the case with my son- after 10 days, he became allergic to it.

-oat beverage: good taste, not the best to cook with. More protein and fat than rice milk. Not good for kids on a gluten-free diet, because although oats don't have gluten there is cross-contamination with other grains during storage.

-hemp beverage: good taste, similar to pine nuts. High in omega 3 and 6, good levels of fat and protein. Not as easy to find in the stores as some other beverages. It is processed in Canada since it is illegal to grow cabannis (AKA marijuana) in the USA; hemp comes from the plant's seed and doesn't contain THC!

-hazelnut beverage: tastes distinctly sweet and nutty. Not good for kids with nut allergies or those at risk for it.

-Dairy-Free (R) beverage: made with potato flour, no fat, cholestorol or protein. Good if you are trying to lose weight, not good for toddlers who need higher fat levels.

Remember to buy these products that have been enriched with calcium and vitamin D. If you can't get your kids to drink these beverages, then try a dairy-free calcium liquid supplement or chewable vitamin. Also, there are many other foods out there that have calcium either added or naturally in them. Even carrots and broccoli have a small amount of calcium. However, it is a lot harder to get the necessary amount.
Don't forget that when purchasing vitamins or probiotics to buy products for vegans or those that distinctly state they don't contain any dairy or it's derivatives, and for the highly allergenic kids, they shouldn't even consume products that are processed on the same machinery as other products that may contain dairy.

In my house, I tend to stock up on hemp and rice beverages. Well, I'm off to go drink a large glass of rice milk....yummy!

Mind, Disrupted — Policy Recommendations

2010-02-04T17:24:00.000-08:00

Mind, Disrupted — Policy Recommendations