The debate rages on over whether cursive handwriting is still needed in this age of technology.
The reality is that most states no longer require that cursive handwriting be taught as part of a school's core curriculum. Thus, many schools have chosen to eliminate that instruction from their 3rd grade requirements. I am astonished that many parents do not even realize that their children no longer learn cursive handwriting. They assume that their child is learning this skill in school.
See my previous blog on the reasons why I think that cursive handwriting really is still important. In addition to that, let's look at the rest of the world. The USA education standards are falling below many other industrialized nations of the world. Many nations have passed the USA in math and science skills. Most students in other countries learn more than one foreign language. They also teach their children to write in cursive. I believe that languages and cursive writing enhance brain development, spatial reasoning, and critical thinking skills. So why should we give up so easily on giving our children an edge on learning?
Parents, you can teach your children to write in cursive. There are some great resource books on the Handwriting Without Tears website (
www.hwtears.com). These books break down the process of learning to write in cursive into very simple steps. Only 10-15 minutes per day of practice will help you and your child embrace success in learning to write in cursive. The "old" days of practicing pages and pages of cursive are no longer needed.
At Child and Family Development in Charlotte, we also offer cursive handwriting groups, as well as individual occupational therapy. Contact us to enroll your child.
There is an explosion of information about how the i-Pad is a motivating teaching tool for children with special needs. One other way that it can be used is to provide apps to teach children time and money skills. The i-Pad provides opportunities for repetition that cannot be replicated using worksheets. The graphics and speed are also much better than most computer software programs that are available. Some of my favorite inexpensive apps include:
It's Learning Time
Jungle Time
Jungle Coins
I'd love to get feedback on other apps for time and money concepts that others have used with children with special needs. As an occupational therapist, I feel that it is very important for all children to learn life skills that will increase their independence and allow them to participate in their community in meaningful ways.
In this fast-paced world where we search for the fast and easy way, we are allowing both normal and special needs children to grow up without teaching them to tie their shoes. As an occupational therapist, I have watched children shift to wearing tennis shoes with elastic or velcro fasteners, the explosion of slip on shoes including crocs and flip flops, and even buckles that are mere decorations for a velcro closure. Children are rushed out the door by their parents to get to school or extra curricular activities on time so their parents quickly tie their shoes for them....that is if their shoes even have laces.
It is time to slow down long enough for your children to learn to master some necessary skills. I can't believe the pride that children of all ages feel when they learn to tie their shoes, close their own jacket zippers, or manage their own small buttons, snaps, and buckles.
Most children (even those with special needs) can learn to tie their own shoes using a consistent approach. Have only one person practice the skill with the child so that only one method is taught. There are many good methods, but the key is to break the task down into small steps and be consistent. I always start each step of the task with the dominant hand leaving the non dominant hand as the "holding" hand. Don't move on to the next step until the previous step is learned and mastered. It is also easier to practice with laces that are very long since short laces don't leave enough room to pull through. All it takes is some repetition.
So parents, sit down with your child over the age of 5 and start teaching them how to tie their shoes. Then celebrate with them once they achieve this life skill!
Many years ago I came across an article that was titled "Ambidextrous People are Brain-Damaged". While I don't fully agree with that concept, I do see many problems that occur when a child does not establish a consistent hand dominance.
The handedness of a person is an expression of an inborn natural lateralization of the brain hemispheres where one side dominates. Typical children go through a period where they use both hands equally; then as they start to use a spoon or a crayon, they start to show a preference for one hand over the other. During development in the toddler years, they may occasionally switch hands but will usually go back to using a consistent hand preference which establishes itself as a dominance by age 5 or 6.
In my experience as a pediatric occupational therapist, the children who do not develop a hand preference during the toddler years often exhibit some delays in their fine motor skill development. Is this because of lack of practice in developing refined skills or because of immaturity in brain development? In my experience, a delay in developing a hand dominance is often linked with other developmental delays including: weak core body strength, poor attention, delays in language development, and overall weak coordination skills. Many children who are later diagnosed with attention disorder or learning disabilities often struggled to establish a hand dominance in the early years.
Thus, when our brains and our bodies develop within the natural pattern of lateralization and dominance, there are fewer developmental delays. A delay in establishing a hand preference should be a red flag to look at other areas of development. Once a dominance is established then many people do go on later to develop skills using either hand (such as a switch hitter in baseball), but skill in the dominant hand is essential for normal development.
To 
Our Sponrs
Child and Family Development is ready for the 2011 Down Syndrome Association of Charlotte Buddy Walk. Come meet and greet some of our staff at the resource tables prior to the walk. Child and Family Development will be there to support the Charlotte Down Syndrome community from 2-6 PM at Freedom Park on Saturday October 1st.
Register Online Today!http://dsac.kintera.org/buddywalk
Parents of children with Sensory Processing Dysfunction (SPD) know that going on vacation can be an extra challenge. These children rely on routines, schedules, and consistent exposure to sensory input. As an occupational therapist, I have observed that heavy work otherwise known as deep proprioceptive input is the greatest organizing and calming influence for most sensory processing difficulties. So here are some activities that can be easily incorporated on a plane or car trip. Have a fun vacation!
- Have child run and stop quickly at rest stops or at an airport. Repeat as often as possible and even have them "tag" a wall or person before changing direction.
- Let them practice wheelbarrow walking or walking like an animal at rest stops or at the airport.
- Let them push their feet on the seat in front of them and count to 5. Be clear how many times they can do this and then tell them when it is time to STOP.
- Chew gum or other very chewy snacks (licorice, gummy snacks, bagels, dried fruit)
- Drink thick smoothies or shakes with a straw; thin straws provide more effort.
- Provide a squeezable toy or ball (one without a noisemaker).
- Keep up the deep pressure protocol (brushing) recommended by your OT.
- Let them pull or carry their own backpacks and luggage.
- Have older child push their younger sibling's stroller.
- Give and receive frequent bear hugs from your child.
- Color with crayons or colored pencils.
- Listen to music with a heavy beat (reggae and rock are good) for 10-30 minutes.
Once again, I am getting ready to send an occupational therapy student on her way to becoming a full-fledged occupational therapist after her 3 month internship with me. During these 3 months, I have provided the opportunities and support for her to learn the day to day practical aspects of being a therapist. She now has the confidence and knowledge of performing evaluations, treatment planning, behavior management with children, report writing, and problem solving skills. But I have also gained a lot from this experience.
I have now worked in the field of pediatric occupational therapy for 26 years. When you have worked in the same field for so long, it might be easy to get in a routine and not think outside the box anymore. But I get excited each time a new student enters my world. I love being an occupational therapist and I love to share my knowledge with others. However, the field of therapy is always changing and I glean a lot of up to date information on occupational therapy theory from these students. We are learning from each other. Also, I am constantly having to explain my reasoning and actions to the student so I am forced to rethink whether this is the best possible treatment approach for my clients.
I also get to watch how my clients interact with another person and am often surprised that they will show new skills to the student because there are new expectations for them. My clients and I learn flexibility and I learn that my way of doing things is not the only way and sometimes not even the best way. So as I say farewell to one student, I am already looking forward to the next opportunity to mentor a young occupational therapist.
As a child approaches ages 10-12 months, parents start to anticipate that huge leap in their child's development when they start to walk independently. As an occupational therapist, I often hear new parents proudly state that their child is showing signs of early walking at ages 8-10 months. In this world we seem to make everything a competition so it must be good that your child is "advanced" and starts to walk early. WRONG! Crawling is a very complex skill in which all of the neuromotor systems, our vision, and our sensory processing must all come together.
In NORMAL development, a typical child learns to crawl on their hands and knees around 9-11 months of age. They have now learned to shift their weight forward and sideways at the same time, alternate arm and leg movements, and turn their head in all directions to explore their environment. Many children start to walk early because they lack the skills needed to crawl successfully. Even if they walk early, I strongly recommend that parents provide many fun opportunities for the child to practice crawling. Pop up tunnels work really well for this.
Many children are referred to occupational therapy at age 4 or 5 years because they are struggling to write their letters. One of the first questions that I ask the parent is "Did they crawl before they walked?" Many times the answer is "No". Crawling is the only time in our lives that we continuously push through our hands, arms and shoulders to build the muscles in all of the joints. We must strengthen the shoulder muscles to move our hand across the page when writing. The elbow, forearm, and wrist muscles help to orient the hand and fingers in the right position to hold the pencil. The finger muscles start to develop when a child crawls with a toy in their hand. If any of these muscle groups has not fully developed then writing with a pencil is difficult.
Crawling has one more benefit. The pressure in the hand and through the arm provides sensory information to the muscle and joint receptors so that we can learn where our arm is located in relation to the rest of the body. Also, crawling over different surfaces teaches us to discriminate how things feel. So, please celebrate that your child is crawling knowing that it will provide a foundation for many more skills later in life. It is still within the normal range of development, if a child doesn't start to walk until 13-16 months of age.
When your child's therapist recommends discharge from therapy (either occupational therapy, physical therapy or speech therapy), a parent typically reacts in one of two ways. Either the parent is happy that the child has reached the goals set for them or the parent starts to fear that their child will no longer progress without the regular visits to the therapist. Here are some questions that a parent should ask the therapist before the last visit is scheduled.
What progress did the child make during the course of therapy?
Are there still areas of weakness that need to be worked on at home or in the community?
What activities will help the child to continue to progress?
What are the next skills that the child should achieve during the following 6 months?
Is there additional support available through a school program?
When should you contact the therapist for a re-evaluation?
What if the child has difficulty acquiring new skills on their own?
Is there a different type of therapeutic support needed at this stage?
Most important of all, the parent needs to celebrate that the child is ready for a new stage in their life that does not require as much support from therapists. Your child has acquired a solid foundation of skills that will support their continued progress. It is now time to let them grow on their own. Your therapist has recommended discharge because they see your child's potential to thrive and be successful.
One of the goals of therapy should be to empower you as the parent. If that has happened then you will feel comfortable with the idea of discharge and you will have the confidence to monitor your child's skills and move forward.
Poor Grace! The little girl in this picture is obviously not having much fun on the day of the Royal Wedding in London. As reported, she did not like the noise of the crowds during the carriage ride from the church to the palace and again during this balcony scene. She is obviously experiencing sensory overload from all of the noise. You can see from her facial expression and her response of covering her ears that she has had enough. I am certainly not diagnosing Grace as having sensory issues based on this one incident; however, for many "sensational kids", this type of behavior happens everyday.
Children with Sensory Processing Dysfunction (SPD) don't process sensations the way other people's brains do. Sensations may appear much stronger for them and sensory overload occurs much faster than in others. They may then have tantrums or meltdowns, become shy or withdrawn, and avoid activities that others enjoy. If you notice this type of behavior in your child on a daily basis or it starts to interfere with life (i.e. refusal to attend birthday parties, fear of school, avoids loud places such as church, supermarkets, or malls) then your child might benefit from Sensory Integration Therapy provided by an occupational therapist.
See more information on SPD at
www.SPDFoundation.net or contact us at
Child and Family Development in Charlotte, NC.
John is a 4 year old child with a diagnosis of cerebral palsy (CP). I am his occupational therapist. We interact for only 1 hour per week, hardly enough to make a difference in each other's lives. Yet, because I embrace the approach called Neuro Developmental Treatment (NDT), John's life does change; and because he and his family interact with me, my life changes too.
NDT theory is geared for persons with Central Nervous System dysfunction. Diagnoses may include CP, Down Syndrome, Metabolic Disorders, genetic disorders and a variety of syndromes that impact motor control. NDT certification is available for occupational therapists, physical therapists, and speech pathologists who work with either children or adults. The pediatric certification process is a lengthy process that is completed after several years of experience in your chosen field. Thus, an NDT certified therapist has more experience and practical education to treat Motor Control disorders than a non-NDT certified therapist.
An NDT certified therapist looks at the whole child and his family to determine goals and treatment strategies that will increase a child's function and independence. The therapist then uses a variety of handling techniques during the therapy session to limit the impact of motor impairments and give the child opportunities to practice different types of movement. With more practice and facilitation by the therapist, the new movement becomes automatic and the child is then able to incorporate that movement into daily life.
To find an NDT certified therapist in your area contact
www.ndta.org. We have many therapists at Child and Family Development in Charlotte who are NDT certified or have taken courses to work towards NDT certification.
Everywhere you turn, you read about how to get children to eat more healthy food. There seems to be an epidemic of children who are picky eaters. However, there are also more children whose eating habits can be labeled as problem eaters. Here are some signs that your child may be a problem eater and not just a picky eater:
- Child eats less than 20 different foods.
- When a new food is presented, child will cry and "falls apart" and refuse to try it.
- Child avoids whole categories of food texture or nutrition groups (i.e. vegetables, meats, purees)
- Almost always eats different foods at a meal than the rest of the family.
- After a food jag, child may stop eating a previously preferred food and never want to eat it again.
- Child gags frequently at the sight or smell of foods.
If your child meets any or all of these criteria, you may want to seek help from a feeding specialist. At Child & Family Development in Charlotte, NC, there are several feeding specialists who are trained to use the SOS Approach to Feeding developed by Kay Toomey, PhD. This highly specialized approach uses Sequential-Oral-Sensory techniques to help a child acquire the skills to expand their food choices. We provide individual and group treatment options. Contact us at
www.childandfamilydevelopment.com to schedule an intake with one of our feeding specialists.
The controversy over whether to teach cursive handwriting in our schools continues. Previously I wrote about the motor and visual perceptual benefits for ALL children to learn cursive handwriting because it will strengthen their fine motor dexterity, coordination, and visual spatial skills. Today I want to present a new way to look at cursive handwriting.
Should we teach cursive handwriting as art? Art enhances our lives because it encourages us to stretch ourselves beyond what we see everyday. That is what cursive handwriting has become. Learning to write in cursive will allow us to see what is common (words) in a different way. It will be a connection to the past as only those persons who can write in cursive will also be able to read scripted writing from previous generations. Cursive writing can be an expression of ourselves--a person who enjoys a challenge and can view the world from a different point of view.
So let's rethink the importance of cursive handwriting for this young generation and try to present it in a new way.
Many of us have embraced the Wii and all of it's activities in our lives for weight loss, fitness training, family fun, and social fun. As an occupational therapist, I see so many more reasons for children and adults to participate in activities using the Wii. In fact, we now use the Wii as a therapy tool during our sessions of Occupational Therapy and Physical Therapy with children in our south Charlotte office of Child and Family Development.
The Wii gets all of us moving instead of leading the sedentary lives that have become so common especially among our children. It is an interactive experience that teaches us balance, coordination, eye-hand timing, problem solving, and visual spatial skills. WAIT...this is often what many of the children referred to therapy cannot do. A therapist can help choose appropriate Wii activities to strengthen the skills that are lacking in uncoordinated children. Practicing at home can be fun because the Wii is motivating, and it becomes a great social activity when done with family members and friends.
Have fun playing Wii with your children. It can be great therapy for all ages and levels of ability. If your child has coordination problems that affect more areas of their life (riding a bike, tying their shoes, buttoning, handwriting), then call us to schedule an appointment for physical or occupational therapy.
I discovered the career of occupational therapy at a young age by seeing an Occupational Therapist on TV (Marcus Welby MD for any old timers). I have never regretted choosing this profession. Working with children keeps me young and stimulated. You never know to expect day to day when you are with kids, which keeps my job interesting.
Especially in Charlotte, NC, there is a strong demand for OTs and the pay is very good too, which is a very positive thing in our current economy. I have especially enjoyed my 15+ years working at Child and Family Development because I have the support of an awesome team of clinicians. Not only do we have a fun group of OTs but I have also learned so much from our interdisciplinary team of physical therapists, educational specialists, psychologists, and speech therapists. We constantly challenge each other to think outside the box and help our clients progress to new levels. Each day I learn something new. How many people can say that after working 25 years in the same field?
On top of that, I have had the pleasure to work with some of the most committed families in my years at Child and Family Development. These are families who desire to understand their children better and willingly participate in their child's therapy sessions and home carryover programs. They teach me creative ways to incorporate therapy activities into their daily lives. This partnership ensures that children will reach their goals.
So, if you are currently an OT looking for a new opportunity, join us at Child & Family Development, in Charlotte, NC. Our website (
www.childandfamilydevelopment.com) will give you information on current job openings. If you are someone looking for a new career, please consider occupational therapy.
www.AOTA.org is the professional organization for occupational therapists and will give you information on how to get started.
Many young children are referred to occupational therapy due to concerns with sensory issues such as: Easily distracted or upset by sounds, not enjoying touching wet textures, being bothered by clothing, not able to sit still, lacking self-control, very active and does not follow directions. It is often my job as an occupational therapist to diagnose whether the child has sensory processing issues or whether something else is contributing to the child's unusual behaviors. Often the answer is more complex and the child may have several issues contributing to their difficulties.
Especially in young children, it is important to treat the sensory issues first since the primary way of learning in children under the age of 5 is through sensory exploration. If the sensory information is confusing to the child then appropriate behavior, self-control (including adequate attention), and learning will not occur. However, many young children with immature sensory processing abilities may also have an underlying attention deficit disorder. How can you tell the difference?
If the child's main difficulty is sensory processing dysfunction then sensory input will quickly change the immediate behavior but if ADHD is the main dysfunction, then sensory input alone will not make a difference. Here are some additional contrasts between sensory dysfunction vs. ADHD behaviors. For more information, please refer to the book Sensational Kids by Lucy Jane Miller, PhD, OTR or contact an occupational therapist at Child & Family Development in Charlotte.
Impulsivity:
Sensory--will stop impulsive behavior with sufficient sensory input.
ADHD--cannot stop impulsive behavior with sensory input.
High Activity Level:
Sensory--craves activity that is related to sensation (deep touch or movement that changes the head position)
ADHD--seeks novelty
Lacks self control:
Sensory--seeks a lot of touch by pushing, poking others.
ADHD--tends to talk all the time; interrupts; not able to wait turn.
Doesn't finish tasks:
Sensory--avoids starting the task, but able to finish when prompted.
ADHD--Can start tasks, but not stick with them.
Difficulty focusing:
Sensory--not interested enough to focus on the material/task.
ADHD--Gets started but focus gets diverted easily and makes mistakes.
Does not follow directions:
Sensory--poor awareness of directions given, poor motor planning so can't follow directions.
ADHD--no motor component issues that prevent child from following the directions; can't remember long list of verbal directions.
Recently, one of my co-workers was planning a trip to Europe and a parent mentioned to her that going on a trip is like having a child with a disability. Many of my co-workers had never heard of the story written by Emily Perl Kingsley (1987)about signing up for a trip to Italy but landing instead in Holland, which described her own journey in understanding what it means to be a parent of a child with a disability. I encourage each of you to look up this heartwarming story on the Internet. I won't copy it here for you as it is a copyrighted story, but it is readily available on many sites.
As for me, I LOVE to travel and if I didn't love being an occupational therapist, I would change careers and become a travel agent. However, one of the most rewarding aspects of my profession as an occupational therapist is teaching families how to embrace and navigate the new world that they are sent to when a child is diagnosed with a disability. I help to teach the families a new language (sensory processing, muscle tone, modulation, fine motor dexterity, oculomotor control, dysgraphia), provide them with a "guidebook" of home activities to help their child, and develop an itinerary with them (treatment plan).
Along their journey, I give them more information so that the parent feels empowered and can now take others along on their journey (grandparents, siblings, friends, and other parents who are experiencing difficulties with a child). A successful "trip" through therapy is when the family better understands their own child's needs, challenges, successes and failures and feels that they can continue their journey with enjoyment versus fear of the unknown.
So...Welcome to Holland (the world of disabilities)....It may not be where you planned to go but it can be a fun and interesting place too.
Recently the media (including Time magazine and the Charlotte Observer) has published several articles about the fact that Cursive Handwriting is a dying art. Schools are barely teaching cursive handwriting anymore since it is not included on end of grade tests. While students may receive some instruction in Cursive writing in the 3rd grade, without practice it does not become an automatic and proficient skill for many children. There is also no requirement to use cursive writing in many schools so students revert back to printing, which is easier for them. There is also the argument that this generation of students will use the computer for much of their writing. So, why is cursive writing still important?
As an occupational therapist in Charlotte, I am observing a generation of children who are not fully developing their fine motor skills. This is true for typical children as well as children who are struggling in schools. The small muscles in the hand develop as we use them for precision skills. Handwriting is one of those precision skills. We use different sets of muscles to hold the pen correctly with a tripod grasp than with a less refined grasp. Cursive writing is usually taught later than printing because we need even more muscle control to guide the pen smoothly across the page as we connect the letters to form words. The stop and start movements in printing do not encourage those muscles to develop endurance or "flow" as cursive writing teaches. These same muscles are the ones that help children with manipulating clothing fasteners (Can they button and tie their shoes well?) If we raise a generation of children that don't fully develop their dexterity then who will take over the jobs later that require fully developed fine motor skills (surgeons, scientists, computer technicians).
Cursive also teaches spatial skills as we automatically leave spaces between words while writing in cursive. This helps to develop visual skills in a way that video games cannot reinforce. Also, if children never learn how to write in cursive, they may also struggle to read cursive writing. So much of what is written in historical documents will be as a foreign language to them.
In recent years, I have had great success as an occupational therapist in teaching cursive writing to children that are struggling to develop neat handwriting. One group of students that has shown the greatest success is middle school age students with Down Syndrome. These are children who typically struggled in their early years to learn to write due to poor fine motor coordination. Once we start cursive writing lessons, their overall fine motor dexterity improves significantly. They also improve their reading skills as they learn to see how letters form to connect words rather than writing individual letters that may not be connected at all by their visual systems. Most importantly, their self-esteem improves as they are proud of their work that looks "grown-up" in comparison to many of their peers.
Let's not handicap our students by not allowing them to fully develop their motor and visual coordination skills. Let's not limit their future career choices because they don't have good fine motor coordination. Cursive handwriting practice does so much more than take up precious time to learn in the schools, but actually enhances skills in many other areas.
The great majority of all child development in the first few years of life involves sensory input and movement within the child's body. Each sense works with the others to form a composite picture of who we are physically, where we are, and what is going on around us. Sensory Integration is the critical function of the brain that is responsible for producing this composite picture. A child develops sensory integration by interacting with his environment and responding to it. This occurs in the course of ordinary childhood activities.
Play offers the child a great way to engage with others while providing them with the stimulation they require to learn and practice new skills and behaviors. Very specific neurological development occurs when a child is stimulated through touch, movement, sights, and sounds. Playing with children can create more integrated children who are better able to handle stress and change and contributes to a strong bond between parents and children.
As an occupational therapist in Charlotte I am seeing more and more children whose early experiences do not support sensory integration. Learning problems at school, hyperactivity, over-aggressiveness, or lack of physical coordination are some of the ways that children deal with an inability to integrate what they see, hear, feel, smell, and taste. While play will not "fix" these problems in a child, it will provide a stronger foundation for developing skills and self-esteem needed later in life.
I want to encourage parents to engage in spontaneous play with their children. Let go of yourself when playing with your child. Children adore the silly, fun-loving side of parents and you might find that your own stress level decreases at the same time. Try messy activities, have a water fight outdoors, dance together, sing silly songs, teach them some of the games you played as a child, jump rope, try a hula hoop, play board games.
Then if your child does not enjoy these play activities, does not follow directions well, avoids movement or messy activities, or has poor coordination; you might want to have your child evaluated by a pediatric specialist in occupational therapy, physical therapy or speech therapy. We can help.
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