Heart to Hands

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.