Good thing OTs are resourceful!

When you are a busy working mom/business owner, you are bound to forget a few things here and there…maybe sunglasses, cell phone, checkbook….but my entire work bag??!? Really, I arrived at my first home health visit yesterday and realized I had no therapy bag! No “bag of tricks”! I had a full day of kids back to back, so no time to run home. What on earth was I going to do with these kids all day?

I frantically searched my car for something that could be turned into something therapeutic. Fortunately I had some yard sale labels, masking tape, and a calculator for my sister’s yard sale this weekend, so I grabbed them and headed in. It worked out to be the best day of therapy I have had in a long time!

I had my students come up with prices for items in their house, then write the prices on the very tiny price tags. I was glad they were so tiny because that called for some intricate fine motor skills to not only write numbers on them, but to hold the price tag still with the stabilizing hand. They then had to use both their hands together and some pincer strength to tear off masking tape and tape the price tags to items around the house.

Then they went shopping! It was a blast. We even had some moms and siblings get involved in the “in house yard sale”. After gathering the items that we were purchasing, my students removed the price tags, again using some distal finger strength and bilateral integration of two hands working together. I had them write down all the prices on another piece of paper which used some nice visual motor skills.

Then the math skills came in. We used the calculator (nice finger isolation practice) to compute the prices that we owed. The kids loved it and we worked on so many great skills!

It was very gradable too! I had young children with autism and downs syndrome and I had a few teenagers with visual motor/fine motor delay and this activity had something for everything. Next time my five-year-old nephew comes over to play, I am going to do this activity with him. He will love writing on the price tags and using a calculator.

Maybe forgetting my therapy bag was the best thing I could’ve done that day!

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It’s all about connections

I always start my baby development trainings with this fact: “Did you know that your baby takes in so much new information in the first year of life that their brain will actually double in size?”

I love that fact. It fascinates me! I just read that by eight months babies brain synapses have increased from 50 trillion to 1,000 trillion, and remain there through early childhood. Isn’t that interesting!?! Our babies are like little sponges from the moment they are born. It certainly doesn’t look like they are learning as they lie there sleeping, eating and pooping, but science shows that they certainly are. Imagine learning so much in eight months that your brain actually more than centuples (yes, that’s a word. I looked it up) in capacity?

When babies are born most of their neurons, or brain cells are already in place, but there are very few connections, or synapses between them. Over the course of the first year, when babies are exposed to new experiences, new learning takes place, these neurons fire off and synapses form.

Babies are taking in tons of information from all of their senses and using that to form new connections in their brain for the basis of all future learning. That is why OTs talk so much about sensory processing and sensory integration. It is so important that babies are exposed to different auditory, visual, tactile, scent, touch, and vestibular (balance) stimulation because that is how these new pathways form.

The other critical piece is that even after these new pathways are formed in the brain, they need to continue to be stimulated to remain there. If they are not stimulated regularly they die away in a process called pruning. Over the next few years (basically toddler years) the brain keeps the connections that are regularly used and prunes out the connections that do not get regular stimulation. That’s another reason why it is important to talk to babies, move babies, massage babies, read to babies, sing to babies, take them outside, push them in swings and on and on and on. Everything we do helps these connections form and continuing to provide them with new experiences helps these brain connections to last a lifetime!

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The eyes have it!

As I watched my 20-month-old niece swipe to open my iPhone, scroll across to find Temple run, then begin playing Temple Run with the dexterity of a teenager, several things come to my mind. I am impressed my her visual-motor skills, fine motor skills and cognitive abilities to learn the game, retain that information and apply it on her own. But a more concerning thing does come to mind. She is not even two… how will this activity effect such young eyes?

I can remember when my daughter was three and I asked her to move back from the TV and she innocently asked me why. I explained to her that it was bad for her eyes to sit so close and she quickly responded with “you sit even closer to your computer, what’s the difference?” Sidenote: she will be a lawyer! She is only in eighth grade, but mark my words, she will be someone who agues for a living. She has been arguing me under the table since she could talk.
Anyway, what is the difference? As kids are exposed to more and more screen time, what can we do as parents to protect their peepers?
In my research I came across the 20-20-20 rule. The American Optometric Association offers it as a guideline when children are watching TV, using hand held electronics or working on a computer. It means every 20 minutes encourage your child to look at something 20 feet away for 20 seconds to give her eyes a break. They also recommend positioning computer monitors at a height so that the screen is 4-5″ below child’s eye level and the screen should always be at least arm’s length from her face. You could also reduce glare on screens by altering the light in the room to help with eye strain.

Overall, it is important to remember to place restrictions on screen time for a number of reasons, not just vision. Reducing screen time keeps children more physically active and encourages them to actually engage in activities. Temple Run is fun and it does give those tiny fingers a work out, but how about setting up a “temple run” obstacle course in the backyard or even the living room with sofa cushions?

It is important to remember that all screens count as “screen time” and when we live in a world with so many screens, it adds up quickly. From the DVD player in the back of the minivan, to Disney games on the computer, to Nick Jr. on TV to scrolling though pictures on an iPhone, these all need to be limited to less than an hour a day according to the American Academy of Pediatrics.

Studies show that 79% of parents are concerned about damage to their child’s eyes due to excessive screen time. The American Optometric Association explains that the screen time itself does not damage young eyes, but looking at screens up close does cause eyes to focus in an unnatural way that can worsen eye problems that may already exist.

So, parents, like so many things…moderation is key!

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Honoring new mommies this Mother’s day

Amanda and Mason

I would like to dedicate this blog post to my favorite new mommie, my sister-in-law, Amanda. Little baby Mason was just born two weeks and three days ago and would you believe he was born with a mohawk? Full head of jet black hair, absolutely adorable and perfect. Yes, I am a proud auntie! :) This is the second child for my brother, Jesse and Amanda. Their daughter, Lili just turned two last week, so needless to say, they have their hands full!

After a difficult pregnancy of gestational diabetes, pre-eclampsia, and intermittent bed rest, (while taking care of a toddler) Amanda spent two and a half full days in labor to produce this little bundle of joy.  Despite all that, Amanda is doing great and just so in love with little mason. I remember that feeling vividly. For me, it was sort of an odd revelation. I guess I thought after marrying my husband that I would never have that feeling of falling in love again. That genuine “butterflies in the stomach”, all-consuming feeling of overwhelming love for another human being. When I had my first daughter, it sort of snuck up on me and took me by surprise. I mean, I knew I would love my baby, but I was definitely unprepared for how overwhelming it would be. When I had my second baby, I was prepared and ready and it was just the sweetest feeling in the world.

Some other mommies have told me it takes different periods of time for the “falling in love” to happen. I guess it is just part of bonding and it is a process. I know Amanda is so in love right now. She is just swooning over that gorgeous little man in her arms. I can see it in her eyes and it is the most beautiful thing in the world.

Along with that unconditional love comes such an incredible responsibility! We, as moms and dads are the only ones who can truly know our babies and care for them in exactly the way they need us to. That revelation terrified me to the core as I held my new baby. The assumption that I was solely responsible for the well-being of this new little person. Her health, her development, her intelligence, her spirituality, her self-esteem, her emotional growth, her ability to grow up into a well-adjusted human being. It was daunting. I say assumption because I quickly learned that it was not solely my responsibility. My whole little community rose up to my aid immediately. My husband, my parents, my in-laws, my sister, my brother, my friends, my pediatrician, the list goes on and on. I continue to draw on the assistance of my entire community in raising my 14-year-old and 11-year-old daughters. Now instead of babysitters and library story-time, I rely on teachers, coaches and car-pool. It truly takes a village.

New mommies often don’t know this or aren’t ready to accept it. They want to do it all themselves, even admit to feeling like a failure if they raise the white flag for help.  As a second-time mom, Amanda knows this now, but it is still difficult. She has support of family and friends, but she would rather do it all herself. Amanda is a smart mommie, though. She knows that in order to truly take care of herself, she has to take advantage of help when it is offered. It only makes us better moms. I keep learning that lesson over and over, still to this day.

I make home visits to teach new parents baby massage all the time and I see tons of emotions when I walk into the house of a newborn. I see joy, excitement, love, and so much affection. Underneath all that I see anxiety, apprehension, and sometimes even a little hint of panic. I just want to hug these moms and tell them “it’s going to be ok!” “You are doing a great job!” Often when the dad or mother-in-law leaves the room, they whisper to me, “this is harder than I thought!”, “I don’t know if I am doing this right!”, “What if I screw this up?”

I love new mommies so much. They are trying so hard and they are so well-meaning! Oprah put it best when she said it is the hardest job in the world.

As I sat in the nursery with Amanda while she struggled to get Mason to latch on, she showed me all the new things she got for him. The new baby swaddle blankets to properly swaddle and calm him, the Baby Connect app to track his feedings, the black and white mobile to visually stimulating him…just wanting to give him all of the best!

That’s why I do what I do. The entire mission of Aimee’s Babies is to empower mommies with all the education they need to give their babies the best start possible. It doesn’t take much; a lot of love, a little knowledge, and a ton of confidence. I hope that the information I put out there through my DVDs, apps and website give new mommies that sense of confidence. When we know better, we do better. I just want to help mommies feel like they know better.

Mommies, you got this! Just like Amanda you are strong, and brave, and knowledgeable, and such incredible mommies! Happy Mother’s Day!

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April is Occupational Therapy Month!

Happy OT Month! Now these are some enthusiastic OTs!

I love being an independent contractor! I can set my own hours and work from home. I love having my own business! I can represent myself and be my own boss… But there is one month during the year when I miss working in a therapy clinic.  April- Occupational Therapy Month. Occupational Therapists really celebrate this too, not only because we are fun people and we know how to party, but because we love our profession! We really do and we are proud to talk about it, brag about it and party in the name of it. We party the entire month of April. We party until our Physical Therapist and Speech Therapist counterparts are sick of it.

“Do you really have to make your patients bake more cupcakes?” “Do you really have to invite the entire hospital to come tour the therapy gym?” “Do you really need to decorate with streamers and put all your adaptive devices on display?” Yes, we do.

Occupational Therapy is such a diverse field. In what other field can you work with a premature newborn in a NICU, a six-year-old in a second grade classroom, a 100 year-old man in a nursing home, a bipolar war veteran in a veteran’s psych hospital, a construction worker on a job site, a brain injured person in an out-patient facility, a grandmother in her own home, or an amputee learning to walk on his new prosthesis for the first time?

It is a profession that calls for compassion, skill, ingenuity, creativity, resourcefulness, imagination, and a sense of humor!

Since I graduated from good old Misericordia University (it was College Misericordia when I went there) back in 1996, I have pretty much worked in every realm of OT I could. I just wanted to experience it all. I did in-patient, out-patient, acute care, trauma, psychiatric care, school-based therapy, home health therapy, geriatrics, pediatrics, neonatal intensive care, and of course rehab. In rehab I had the opportunity to work with spinal cord injury, brain injury, stroke, orthopedic, cardiac, and amputee and I loved it all. No matter what area I have worked in, I always love being surrounded by other therapists and my patients. I think spending my day with rehab patients is my favorite part of being an occupational therapist. Rehab patients are not the same as any old patients; rehab patients are different. Rehab patients, whether a small child learning to color, an adult learning to walk again, or an elderly person learning to dress themselves again, all have something very special in common. They have a determination. They are overcoming something huge, striving for recovery, independence, success and I am so privileged to be a part of that. I believe that we absorb the energy of those around us and even though my patients may become discouraged or frustrated at times, they have such a positive energy about them.

I can’t believe I have been practicing occupational therapy for 17 years! I like the phrase “practicing occupational therapy” because it is a practice. There is always room to improve, always something new to learn, always advancements and new techniques to benefit us as therapists and our patients.

In the past 14 years I have settled into the role as a pediatric occupational therapist or some people would say “specializing in pediatrics” and I could not love it more. As I said, all rehab patients are amazing and incredibly inspirational to me, but nothing beats the resolve of a child. There is no hurdle they will not attempt. They act as if they can overcome anything and so many children with disabilities seem as if they do not even know they have a disability. They are completely unfazed. They think therapy is playtime and they attack it with enthusiasm. I absolutely love celebrating every tiny accomplishment and milestone with the parents of these precious children.

So, I may not have a therapy gym to decorate or a “Happy OT month” cake, but I have my love of my job. My love of my profession. The celebration of every small accomplishment of all of my patients. Happy OT month to all the other hard working occupational therapists out there!

Thanks for reading!

 

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“Grasping” for answers

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When should you expect your child to pick up a pencil, hold it correctly and color within the lines or draw shapes or letters? Well it is different for each child, but here are the basics:
Most children don’t establish hand dominance until at least at least age three, and some children are still switching hands by age four or five. Allow your toddler or preschooler to switch their crayon or pencil from one hand to the other because it helps to develop their brain on both sides.

The first grasp pattern you will see is mist likely a “whole hand” grasp where all five fingers are wrapped around the crayon inside their fist. Try to encourage them to have their pinkey pointed down and there thumb pointed up so their forearm is not twisted.
Eventually they will drop their pinky out and hold the crayon with four fingers.

The desired end result is a tripod, or three finger grasp with the pencil resting on the top, inside of the middle finger. It does take a while for those tiny fingers to achieve a tripod grasp, but there are some ways you can help.

Crayola makes round crayons that automatically help the fingers to fall into a tripod grasp. There are also triangular crayons with three sides that help those tiny fingers fall into place. You can also get a triangular pencil gripper and slide it on to a pencil or crayon. Using very tiny pencils helps to establish a three finger grasp because it is too small to hold in their fist.

There are also some exercises to help strengthen those little fingers. Use clothespins, stringing beads, paperclips, and small wind up toys to get the thumb, index, and middle fingers to work together. Use play dough and silly putty To help strengthen that hand.

Don’t get frustrated. This is a difficult skill to master and some children still work on it into second or third grade.

Just provide your child with lots of experiences with crayons and coloring books and pencil and paper!

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April is Autism Awareness Month

1 in 88! Astounding numbers. 1 in 88 children are diagnosed with autism today according to the CDC. (1 in 54 boys and 1 in 252 girls, so it is 5 times more common in boys.)

According to Dr. James M. Perrin, the president-elect of the American Academy of Pediatrics, the number has risen due to increase in diagnosed cases that may otherwise have been overlooked, and an increase in genetic predisposition. Dr. Perrin will be the 2014 president of the Academy. He is a professor of pediatrics at Harvard Medical School and heads the division of General Pediatrics at the MassGeneral Hospital for Children. Dr. Perrin leads the Clinical Coordinating Center for the National Autism Speaks Autism Treatment Network to improve care for children with autism and other developmental disorders. He continues to push for early identification and early intervention.

There continues to be no known cure for autism and no way of preventing it. The best we can do as parents and practitioners is know the early signs and seek intervention as soon as possible. Why is it so important to get therapy so quickly, you might ask. Can’t I just have time to process this diagnosis? No, it is critical to start therapy right away because babies’ brains are developing at a very rapid rate and it is really important to take advantage of that “neuroplasticity” or ability to “re-wire” the connections in the brain while the wiring process is still happening. Studies have shown that when intervention is started in babies as young as 18-months-old, the effects of autism can actually be reversed because the still-developing brain can actually be re-wired.

The difficult thing about autism and all the autism spectrum disorders (ASD) is that they are not diagnosed by abnormal behavior, but the absence of normal behavior. Parents need to educate themselves on normal behavior and typical development so they are aware when something is missing. Something as simple as a missed early milestone can be a huge red flag.
Learn the early signs here at autism speaks : http://www.autismspeaks.org/what-autism/learn-signs

Does anyone have any success stories from early intervention? Please share…

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Go big or go home

The lady at the post office thinks I’m crazy. She looked at me quizzically over the rim of her glasses as she stamped the stack of letters I gave to her.

So I mailed out proposals today to a few people I am hoping might be interested in helping me spread the “Aimee’s Babies word”.  I know that these people will help me reach my target audience and since my target audience is just every new parent in the world, I’m going big.  I sent my DVDs and proposals to Michelle Obama, the American Academy of Pediatrics, The Today Show,  Rachael Ray,  the president of Chicco baby products, Parents magazine, and of course, Oprah…again.

Last week I evaluated an eight-year-old newly diagnosed with an autism spectrum disorder.  Upon a history review with his parents, I found out about early missed milestones and reflexes that never integrated, and all sorts of early signs of autism that were missed.  Early intervention could have made a huge difference in this child’s life, but he was not identified as needing it.  Of course his parents have the best intentions, but they did not know what to look for.

The hardest part about identifying autism spectrum disorders or many developmental delays for that matter is that they are not identified by abnormal behavior, but the absence of normal behavior.   The loss of skills, missed milestones, and the absence of developmental milestones tell us so much, but in order to notice what’s not there, parents have to know what should be there.  Parents are the front line, they have to be educated and vigilant to their baby’s development.

Parents don’t have to watch Aimee’s Babies videos to get the education I’m talking about (of course they can, and I would certainly recommend it) but parents can take classes, read books, and find the necessary resources. When we know better, we do better and that’s all I’m asking. I want parents to take the responsibility to be their child’s advocate. Don’t rely on a 10 minute pediatrician visit or preschool teachers to point out issues. Educate yourselves, trust your instincts and advocate  for your babies.

I really appreciate you reading my blog, but not every new parent reads my blog, so that is why I am appealing to the big wigs to help me spread the word. I am looking for a larger platform.  I just want to put some information out there and empower parents to give their babies the best start possible!

I hope someone responds, but  I know they are busy. Michelle Obama and Oprah both have some other things on their plate. Maybe you can help me spread my word…

 

 

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Easter activity for fine motor skills

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I decided to do an Easter activity yesterday with some of my young patients. I filled a container with navy beans and hid a bunch of tiny chicks in it. The kids use tiny rakes to locate the checks and then they used Chopsticks to pick them out of the Navy beans. After they had the chicks out of the beans they opened up the Easter eggs using two hands and put each chick inside one Easter egg. (Sending the chicks back home).
The kids loved it and it was a great two hand activity! It also utilized some fine motor strength and a pincer grasp similar to that used for a pencil grasp.

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Baby Vision- part 2

There is so much information about babies developing vision, that I can write about it all day long. I decided to split the information into two separate blog posts. This is the Part 2. Check out Part 1 for visual developmental delays.

So, let’s talk about what babies can see. Up until about three months babies can see objects best when they are 10-12 inches from their faces and their peripheral vision is actually more acute than straight ahead. Aha! We used to think that babies had no peripheral vision! If you look closely, you will notice that newborn babies will turn their head away from you, then look at you out of the corners of their eyes. That is not due to lack of control, they are doing that so they can see you better. Babies are so smart!

Along with visual acuity, visual motor skills (or coordination of the tiny muscles around the eyes) are developing throughout the first year and both components need to be exercised simultaneously. Visual motor skills are important for scanning, reading, and catching a ball.

Did you know that crawling helps the development of vision and visual motor skills? This is the case for two reasons, first of all, babies are close to the floor where all their toys are and the proximity and movement stimulates their eyes. The second reason is the most fascinating to me. Because the left side of our brain controls the right side of our body and vice versa, the two sides of our brain need to learn to communicate and work together for us to have coordinated movements. As babies crawl and use their entire body reciprocally, the corpus callosum, or the part of the brain that connects the two sides together is very stimulated. This stimulation strengthens the corpus callosum, building the connections between the two sides of the brain; and since both sides of the brain need to work together to perceive what your baby sees, crawling is enhancing visual skills and helping to build a foundation for good lifelong vision and reading skills.

Remember, even though their vision is not as acute as adults, babies can see at birth, so use that skill to help build those essential connections in the brain. Give babies lots of opportunities to focus those new little eyes and let them see your smiling face so they know how very much you love them.

Please check out my Aimee’s Babies Vision app for specific visual exercises you can do with your baby and visual images that will stimulate your baby’s emerging vision skills.

 

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