Occupational Therapy in Charlotte

 

 

 

 

 

 

 

Just as some children can be overly sensitive to touching typical textures or fabrics, other chldren with sensory difficulites may display "tactile" seeking behaviors. These behaviors may go unnoticed unless they begin to negatively influence everyday functioning or they are paired with additional sensory challenges.

Signs that your child might be seeking touch input, can include:
- irritating others because the child touches objects or people often
- is unaware when someone touches them on the arm or back
- prefers to be barefoot and avoids wearing shoes
- doesn't appear to notice when hands or face are messy
- decreased pain or temperature awareness
- unusual need to touch certain textures, surfaces, or toys

Parents are often aware that their child demonstrates some sensory activities that may stand out from the crowd. As an occupational therapist, it is my goal to intervene when children begin to demonstrate difficulty with everyday tasks or demonstrate delayed development. If you are curious about whether or not your child would benefit from an occupational therapy evaluation, call Child and Family Development to schedule a free phone call with a pediatric therapist to address your concerns.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I recently attended an online webinar on Therapeutic Listening: Listening with the Whole Body. Therapeutic Listening is a sensory integration intervention for children with sensory processing disorders, attention challenges, and motor planning issues. It is specifically designed to address auditory sensitivities; however, because of the anatomy of the inner ear, sound is able to affect both hearing and the vestibular systems simultaneously. This affects hearing, sound localization, and the awareness of where our bodies are in space. Awareness of timing and where our bodies are in space are essential for motor planning and praxis skills. The signals are transported from the ear and processed through the nervous system, creating integration with additional systems that influence coordination of movement, attention, sleep/wake cycles, bowel/bladder control, emotional regulation, and feeding. It was an excellent course that explained the anatomy and use of this exciting tool. I am looking forward to incorporating it into my personal practice and educating parents on the possible benefits of this program.

For more information on Therpeutic Listening, visit Vital Links

 

 

 

 

 

 

 

 

 

 

 

Picky eating is a common concern reported by parents. Picky eating can also be a serious issue when a child's diet is highly limited due to oral sensitivity.

Some signs of oral sensitivities can include:
- gagging easily when food or utensils are in or near the mouth
- avoiding food smells or tastes that are a typical part of other children's diets
- eating foods of one or few tastes/ temperatures/ textures 
- being considered a "picky eater"

If you are concerned about your child's diet, nutrition and eating, consider a formal evaluation with an occupational therapist, a speech therapist and/or a dietitian at Child and Family Development.  Members of our pediatric therapy team have special training and expertise.

 

 

 

 

 

 

 

 

 

While most children enjoy playground activities, like swings, slides, and merry go rounds for limited periods of time. Some children just can't seem to get enough of it. Playground activities, which provide "vestibular input", including head movements through space, are beneficial to the vestibular system and a natural part of childhood development. As mentioned in my previous blog, avoidance of these activities can be a sign of sensory challenges. In addition, seeking out to much vestibular input, can interfere with functioning on a daily basis.

The following are signs of vestibular seeking behaviors:
- seeking out so much movement that it interferes with daily routines (like moving in a seat or fidgeting)
- rocking in a chair, at a desk, or on the floor
- rocking without being aware of the behavior, like while watching television
- seeking out all kids of movement activities, including moving toys, playground equipment, or merry-go-rounds
- spinning self or twirling self frequently throughout the day
- enjoys feeling dizzy or doesn't become dizzy like expected

If your child displays excessive needs for movement, as well as other sensory sensitivities or seeking behaviors, it may be beneficial to pursue an occupational therapy evaluation. If you are based in or near the Charlotte area, an Occupational Therapist at Child and Family Development can help!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The iPad and other technology is making a huge impression on our children. Angry birds seems to be of particular interest with the kids at the South Charlotte office!

I recently purchased an iPAD and I am exploring the use of apps in treatment sessions. I am very interested in how to make handwriting fun. One of my current staples for letter formation is "Letter School". It's produced by Boreaal and their website is http://letterschool.com. I copied this image from their website to share with you.

Letter school offers uppercase and lowercase letters and numbers. It includes Handwriting Without Tears® (HWT), D'Nealian and Zaner-Bloser style handwriting. I love that it offers HWT style letters which is what we often in occupational therapy interventions. It also provides consistent formation which is very important for kids who have a hard time with handwriting. The app requires proper sequencing of formation and progresses in independence with each letter.

On the first attempt, children are simply required to locate the starting points and the app shows them where the lines should be formed. The second attempt requires the child to complete the tracing, and reinforces the formation with visuals of trains, lights, or lawn mowers to name a few. On the third attempt, the child is required to form the letter without any visual cues. Once the child has mastered all of the letters, there is a second level with new visuals to provide practice.

I love this app because it is fun and accomplishes education on basic letter formation, while allowing the child to show off what they have learned!

Children with visual processing difficulties can sometimes be difficult to identify because the subtle characteristics that typically go unnoticed.

Signs of visual defensiveness can include: 
- preferring or happy to be in the dark
- avoiding or showing discomfort in response to bright lights (asking to turn of the lights often during the day or hiding from sunlight are two examples)
- squinting or covering eyes to protect them from bright lights
- having a hard time putting together age-appropriate puzzles
- frustration with finding objects in a messy room or cluttered drawer
- continues to be bothered by bright lights when everyone else has already adapted to the light

One challenge with visual defensiveness is that children can easily become overwhelmed by too much input in everyday environments. This can lead to challenges with functioning, behavior, and emotional responses since the child's sensory system is unprepared to process the visual input in our typical environments. If you are concerned that your child may have difficulty with sensory processing, contact an Occupational Therapist at Child and Family Development. We help families through the process of identifying and treating children with sensory processing challenges.

 

 

 

 

 

 

For most kids, the playground is a fun place that provides all kinds of movement including swinging, spinning, hanging up-side-down, going down the slide, and hanging on monkey bars. (There are often tactile benefits too of playing in sand!) The kind of movement that playgrounds provide is what occupational therapists would identify as "vestibular input", which is the motion or change of head position. Most kids highly enjoy vestibular activities, but if a child avoids these or similar activities, there may be an indication of sensory processing challenges.

The following are signs of over-reactions to vestibular input:
- intolerant or fearful of unexpected movement
- avoids or is distressed by movement activities
- displays anxiety, fear, or distress when feet are off the ground (swinging, monkey bars, etc.)
- dislikes or avoids playground equipment or moving toys 
- hesitant with stairs or curbs
- tends to be tense and rigid
- doesn't like activities where head is upside down 
- doesn't like riding in a car
- becomes disoriented after bending over a table or a sink

Avoidance of vestibular input can be a sign that there is a larger underlying sensory challenge. The vestibular system is one of the foundational sensory areas, and dysfunction can often lead to challenges in other areas of sensory processing. If you are concerned about your child's sensory functioning and are looking for an Occupational Therapist in Charlotte, contact Child and Family Development. We would love to help you and your family learn about sensory integration.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

We all show a startle response to some loud and unexpected noises. That is a typical reaction to loud noises.

We don't have concerns about auditory sensory defensivenss unless a child demonstrates atypical behavior that interrupts normal functioniong in every day life.

The following are signs of auditory defensiveness:

-         demonstrates distress, hides, or cries in response to loud or unexpected noises (for example, blenders, vacuum cleaners, hair dryer, dogs barking)

-         protects ears from sounds by covering ears

-         difficulty doing tasks when the radio or TV is on

-         hard time with focusing or functioning when there is a lot of noise

-         cannot work with noise in the background, like a fan or refrigerator running

-         notices sounds no one else hears, like a clock ticking, airplane flying over head, etc.

If these and other sensory challenges are beginning to interfere with your child's well being and participation in everyday activities, it may be time to pursue an occupational therapy evaluation. Here at Child and Family Development, Occupational Therapists and Physical Therapists have the opportunity to use Therapeutic Listening as a beneficial tool for addressing auditory defensiveness. To learn more about the listening therapies that we provide here at Child and Family Development, feel free to give us a call, visit our website, or read some blogs, such as http://blog.childandfamilydevelopment.com/blog/candfd-team/listening-therapies-at-child-and-family-development

The above symptoms were shared from the Sensory Profile, created by Winnie Dunn, Ph.D, OTR, FAOTA

 

 

 

 

 

 

 

 

 

 

 

Halloween has passed, but dressing up doesn't have to end! There are a number of benefits of having a dress up box for all children, particularly kids with developmental delays, autism, fine motor coordination difficulties, or sensory processing challenges.

Self-Care: One benefit is having a fun way to work on self-care skills like dressing, buttoning, and Velcro. Increasing the ability to dress yourself and work small fasteners is a skill that requires alot of repetition, but using a dress up box as a PLAY activity masks the challenges of these skills and makes practice fun!

Touch Processing: Fill your dress up box with a variety of materials and sensory challenges. Dressing up is often more motivating than trying to address tactile sensitives directly. Provide items like frilly petticoats, feathers, fringe, leggings, princess gloves, animal gloves, masks, crowns, hats, shoes, and other costumes that stretches your child's sensitivity to textures.

Imagination: Imaginative play can be a challenge for children on the autism spectrum, so use dressing up as an opportunity to increase play skills!

Independence: Another challenge for some children, especially those with developmental delays, cognitive deficits or autism can be knowing what is an appropriate article of clothing for the different seasons. A dress up box geared toward this area, could include clothing appropriate for specific seasons and then help your child select his own outfit.

As an occupational therapist at Child and Family Development, one of my goals is to make therapy and learning fun!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Parents with children with sensory processing difficulties sometimes have concerns about touch processing, while others are unaware that their children's difficulties are a presentation of a larger underlying difficulty.

We all demonstrate some challenges with sensory integration.  However, it is when the those challenges begin to decrease our ability to function normally in everyday life that intervention becomes warranted and even necessary. The following are some signs of tactile sensitivity: 
- Avoids getting messy with glue, tape, finger paint, sand, etc.
- Shows fear or distress during grooming, such as fingernail cutting or face washing
- Expresses discomfort or distress with toothbrushing
- Sensitive to certain fabrics, including clothing or bedsheets
- Irritated by socks or shoes
- Avoids going barefoot
- Withdraws from splashing water
- Rubs out or scratches a spot that has been touched
- Has a hard time standing in line close to others
- Reacts emotionally or aggressively to touch

If signs like these are significantly interferring with your child's ability to function in everyday life, it may be time to seek an occupational therapy evaluation to determine sensory processing difficulties. If you are looking for an occupational therapist in Charlotte, check out Child & Family Development, we enjoy working with families and children as they learn to cope and overcome sensory challenges.

The above symptoms were shared from the Sensory Profile, created by Winnie Dunn, PHD, OTR, FAOTA.

Fidget toys are small objects that can be used during school, in the classroom, or at home to focus a need to move, help kids pay attention, or help to decrease anxiety. Children with attention deficit disorder (ADHD), hyperactivity, sensory processing disorder, or anxiety may be able to benefit from a fidget toy. Fidgets should help your child focus, should not make distracting noises, and should not distract other children in your child's class. When fidgets start to interfere with focus and functioning in the classroom, they should be taken away & a new approach should be attempted. Make sure to ask your child's teacher before sending a fidget with your child to school.

More ideas for fidgets, include using small toys that provide additional tactile input, such as squishy, spikey, gooey, and moveable surfaces. A classic figet, or "stress ball", can be made easily at home. Just take a thick balloon, fill it with sand or flour, and tie it securely. You may also want to fill a balloon with playdoh for a different texture, and finger strengthening. 

Make sure to take your childs needs & any safety concerns related to mouthing objects or immaturity into account before providing your child with a fidget. For more information on helping children with ADHD, sensory processing disorder, anxiety, or hyperactivity in Charlotte, NC contact an occupational therapist at Child and Family Development.
 

A fidget is a small object, like a koosh ball, stress ball, pencil, keychain, bracelet, paper clip, eraser, or small toy, that can be beneficial for helping a child pay attention in school, focus a need to move, or deal with anxiety. They are objects that can be pulled, squeezed or moved around with your hands or fingers while paying attention and looking at the teacher. Fidgets can be helpful for kids with ADHD, sensory processing disorders, or anxiety during classroom time or at home.

Before sending a fidget to school with your child, you should ask the teacher for permission. Fidgets shouldn't be used as an additional method of distraction & children need to know that there are rules.

Fidget Rules:
- One is that you shouldn't need to look at the fidget while you use it because then you won't be able to pay attention in class.
- You shouldn't try to get your friends to pay attention to your fidget either, because the other kids are trying to learn.
- It shouldn't be thrown or dropped, it needs to stay on your desk or in your hands.
- Another suggestion is to keep your fidget in your pocket so that you know where it is.

If you are looking for help for your child with school related concerns in Charlotte, consult with an educational specialist or occupational therapist at Child & Family Development.

While certain foods are able to calm, help organize, and sometimes increase attention for children with ADHD and sensory processing disorders (see previous post), other foods are alerting.

Alerting foods can be good to increase the arousal level of children who are typically low arousal. They may also need to be considered foods to avoid during particular points of the day when inattention, hyperactivity, or sensory challenges may be present.

Alerting foods can include:
- CRUNCHY FOOD: like bavarian pretzels, carrots, apples, banana chips, pickles, popcorn, crackers, granola bars, nuts, raw vegetables, etc.
- Sour and spicy flavored foods
- Cold items (ice, popsicles, ice water, ice cream)
- Carbonated drinks
- Sucking on hard candy like Warheads, Fire balls, sour balls, Hot Tamales, etc.

If you are looking for more information on oral strategies, ADD, or sensory processing, consult with an Occupational Therapist at Child and Family Development.

Foods that require sucking introduce fun ways to include proprioceptive input and heavy work to the mouth. Including these foods in your childs diet may be beneficial for children with sensory processing disorders or ADHD. But really, it's not the food- it's the method! For added heavy work, try sucking the liquids through a straw. Consider using sports bottles and straws that require more "work", such as silly straws, long straws, or thin straws.

Foods:
- apple saucehttps://www.compendiumblog.com/web/admin.dashboard
- Charleston Chews
- Flat Sugarless Candy
- Fresh Orange Wedges
- Grape Fruit Wedges
- Jello Cubes
- Tart Juices (Cranberry, Lemonade, Apple, Grapefruit)
- Smoothies
- Milk Shakes
- Peanut Butter
- Popsicles
- Puddings

Not every child will react the same way to oral motor (mouth) strategies like these. For more information, consult an Occupational Therapist at Child and Family Development.

Image: Peter Nijenhuis

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

When discussing strategies for children with sensory processing disorders and ADD or ADHD, one helpful approach which is often new to parents is considering which foods are beneficial to increase attention and provide proprioceptive, or heavy work input to the mouth.

There are a number of foods which may have a calming affect, because of the sensory input provided to the mouth. Some of these foods include: 

- Sucking (ice, milk shakes, noodles, hard candy)
- Using a sports bottle with a straw for increased heavy work
- Thick foods like peanut butter, milk shakes, or smoothies
- Chewy foods like gum, fruit roll-ups, dried fruit, bagels, gummy candy, chicken strips, cheese, taffy, caramels, Starburst, or cooked vegetables

It can also be beneficial to include these foods & techniques in your child's lunch, at snack time during school, and provide a water bottle with a straw throughout the day.

If you and your child are looking for more guidance in the areas of sensory processing or ADHD in Charlotte, consult an Occupational Therapist at Child and Family Development!

With the return to school and Pre-K, there are bound to be new germs entering your child's world. Keeping toys cleaned regularly is one way to keep down the transfer of illness. A fun way to get your kids involved in the clean up and provide a tactile activity is to set up a "Shaving Cream Car Wash". Tactile activities are great for kids with sensory processing disorders, autism, and ADD.

All you need are small toy cars, popsicle sticks, plastic construction blocks, and small balls; shaving cream, a tray, and a way to clean up and dry off. (Other plastic toys can "take a bath" too.) Kids can use their cars to drive through a carwash that they build out of the blocks. Cars can be used to makes lines, patterns, or letters. You can also make a maze with the blocks for cars to drive through an obstacle course. After you are finished with the drive through, make sure to rinse the cars, dry them, and then put them away!

To increase the tactile experience, increase the amount of shaving cream to provide more contact with the skin, and include extra textures in the mix. To decrease the challenge, use less shaving cream, and provide paper towels within sight to ease anxiety about quick clean up when the shaving cream becomes too much.

This activity was shared from: The Out-of-Sync Child Has Fun: Activities for Kids with Sensory Processing Disorder by Carol Kranowitz, M.A. For more great activities in all areas of sensory processing, get your hands on a copy of the book!

 

 

 

 

 

 

 

As school gets back into full swing, working on handwriting and pre-writing shapes often comes home in the form of worksheets, or kids are tired of the traditional method of pencil and paper. This is a fun activity that can be used for shapes, numbers, and letters. It is ideal for any child working on handwriting, fine motor skills, or tactile defensiveness such as children with autism or sensory processing disorders. It would also be appropriate for children with dyslexia, ADD, hyperactivity, learning disabilities, or developmental delays.

Feely Shapes: Fun with Spaghetti!  

What you will need: 
- package of spaghetti
- pot with water
- placemats

Activities: Cook the spaghetti and then rinse it with cold water until its cool enough for little hands to touch. Provide a placemat for easier clean up and encourage your child to make shapes, numbers or letters out of this fun new texture.

The following shapes are appropriate expectations: 
2-3 years old: imitate a vertical line, horizontal line, and circle; copy a horizontal line
3-4: copy a horizontal line and circle
4-5: cross, diagonals, square, X
5+: triangle, make a person, create a picture, uppercase letters, & lowercase letters

Adding different types of pasta will increase the tactile input & creative potential during this activity. If children are afraid to touch the pasta, they should be encouraged, but could use eating utencils to lessen the sensory challenge.

This fun activity is shared from the book, "The Out-of-Sync Child Has Fun: Activities for Kids with Sensory Processing Disorder" by Carol Kranowitz, M.A. which is full of great sensory activities for kids!

As a student, I had the opportunity to do an occupational therapy internship in a relatively large school system outside of Charlotte. After graduating, I decided I was interested in working outside of the schools, in an outpatient clinic. Although an occupational therapist can work on many of the same areas in the school and outpatient clinic settings, there are some key differences that I have learned about and that are key for parents to know.

The first is occupational therapy in school and educational settings are focused on, and even restricted to, areas related to educational participation, these include academic, mobility, psychosocial, behavioral, and self-care. Intervention which is considered to be purely medically necessary and unrelated to accessing education cannot be addressed. The model is based in a team aspect, or a collaboration between the child, family, teachers, therapists, and exceptional children specialists. The classic picture of this interaction occurs in IEP meetings, but collaboration is an ongoing exchange of information and reccomendations between the involved parties throughout the school year. Intervention is often carried out in the classroom or in individual or group pull out sessions during the school day. Intervention for sensory processing disorders with the use of large equipment is often limited, if available, due to a lack of access to equipment during the school day.

Occupational therapy in an outpatient clinic, like Child and Family Development, is also based on a team approach, which is called a multidisciplinary approach. In this model, an occupational therapist, physical therapist, speech therapist, pscyhologist and educational specialist are able to coordinate treatment together. Parents are interviewed and goals are written in collaboration. Information is often provided to physicians and classroom teachers based on parent consent. In the outpatient setting, occupational therapy intervention and goals are unrestricted and are focused on areas of need, including both medical and educational aspects. Evaluation and intervention often includes self-care, play skills, visual motor, motor development, sensory processing, visual perception, visual motor integration, fine motor development, feeding skills, bilateral coordination, social skills, grasping skills, upper body strength, handwriting, and caregiver education.  

These differences highlight only a few of the differences between the two settings, but they bring to light why some children would benefit from either both clinic & school-based therapy; or ONLY clinic OR school-based therapy. For more information on services provided here, visit our website at www.childandfamilydevelopment.com.

One fun & tasty sensory activity that is a classic is doing pudding art! All you need is a box of pudding mix or you can use the prepackaged variety. Instant pudding can be made with cold milk so it can be safe for your children to help you make it, compared to the stove top variety. Use a flat plate or plastic serving tray & scoop the pudding on the surface. Then allow little hands to help spread it out. Using fingers and flattened hands can make great art that can easily be wiped away and done again. It can be a great medium for practicing prewriting skills, drawing, and practicing letters! And, you can eat it of course!

This activity may be overly stimulating for children with tactile defensiveness, which we often see in children with Autism or Sensory Processing Disorders. If your child exhibits defensiveness, encourage them but, don't force them to touch the pudding. Incorporating tools like a spoon or old paint brush could encourage them to continue with playing with the pudding without having to touch it. Add sprinkles, Cool-whip, or other fun toppings to vary the texture! It will take a little clean up, but it will be alot of fun!

Any child would benefit from this activity including those with anxiety, dyslexia, attention deficit disorder (ADD), hyperactivity, and developmental delays! Enjoy :)