Toothbrushing Tips

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!

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

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!

Washing a Kid's Hair Who Has Tactile Sensitivity

My two young kids absolutely love bath time. When they hear Daddy start the water, they dash upstairs to crawl in. They have fun during bath time for many reasons: playing with one another, splashing, playing with bath toys, singing & laughing. My 15 month old son could care less if the water is poured over his head in order to rinse out the shampoo. My daughter on the other hand, acts as if she is dying if any water touches her face. I have her wear a cloth over her eyes and tilt her head back to minimize the damage. If I am washing her hair, all goes well because I am careful to not get any water on her face. When Dad rinses the shampoo, she puts up more of a fight because he typically gets water in her eyes. My child doesn't have sensory processing disorder (SPD) or an extreme tactile sensitivity that I know of, but she is still sensitive to getting water on her face. Once she is upset about the water in her face while bathing, she is over it within 10 seconds after it has stopped. But unfortunately for a lot of the families I work with, once their toddler or young child with SPD or tactile sensitivity becomes upset, it is meltdown city, and then the child is so upset that he can't fall asleep for well over an hour.

While applying shampoo to the child's (with SPD or tactile sensitivity) head, it is a good idea for the adult to put the shampoo in their own palm before applying it to the child's head. The trickle of shampoo over the child's head may be aversive whereas the deeper touch of a palm full of shampoo isn't as aversive, usually. When rubbing in the shampoo, use firm massage strokes. If using organic shampoo without lauryl sulfate, the shampoo may not create suds, therefore suds can't fall into the child's eyes. To minimize water in the face while rinsing shampoo from the sensitive child's hair, try the following tips:

• Have them tilt their head backwards as you rinse the shampoo out



• Have them put a dry washcloth over their eyes as if it is a blindfold. It can catch any stray sprinkles of water



• Use a sun visor to catch any water that would fall down the child's face



• Use a Lil' Rinser (R). They have a website; I purchased one at Target (R). I have only used it a few times, and if put on properly, it helped minimize water in the eyes even if the head isn't tilted back



• Only wash a young kid's hair up to 2 times per week unless they are extra dirty. Since they do not produce as much oil (pre-puberty) as an adult does, they don't need their hair washed as often.



• Get tear-free shampoo and/or shampoo with natural/organic ingredients; this way the shampoo won't be as harmful



• Wash the kid's hair earlier in the day or before supper, not at bedtime. This way if he is upset about it, it won't delay his ability to fall asleep. Many kids with SPD have a hard time winding down to fall asleep on any evening much less on an evening when they became upset



• Consider showers. The deep pressure of water coming from a shower head may be less aversive than water trickling from the faucet or a cup used to rinse out shampoo



• If you are concerned that the your young child may have sensory processing disorder but you are not sure, go to http://www.spdfoundation.net/ for information on kids and http://www.sense-ablebaby.com/ for information on babies.