Preschool Yogis

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The benefits of yoga transcend generations! As moms and dads find the calming, strengthening, and rejuvenating effects of yoga,  preschoolers are finding their own magic in the poses of the ancient art.  Preschool teachers, daycare professionals, and camp counselors are … Continue reading

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What does your baby hear?

Hearing is a very important sense at birth

I happen to have several patients right now with hearing issues and I think we need to take some time talking about the complexities of hearing in babies and young children. According to the American Speech-language Hearing Association (ASHA) two in every 100 children have hearing loss.

Music is great to stimulate a good sense of hearing

Music is great to stimulate a good sense of hearing

Of all the senses, hearing is the most well-developed at birth, providing one of the best opportunities to stimulate new babies and introduce their world to them. The development of hearing in newborns is so acute and rapid that by the age of five months, infants are typically able to determine the difference between two adjacent keys on a piano. Since the auditory parts of the brain are so well-developed at birth, and continue to develop so rapidly, babies are hearing just as well as full grown adults by eight months, because that part of the brain is fully “wired”.

Babies can hear in utero

Babies can hear in utero

Unlike vision, hearing is very developed even before birth, as babies are able to hear in utero. Some experts believe that babies are able to hear for about 24 weeks before birth. The fetus is constantly stimulated by the sounds, movement and vibration of the amniotic fluid, placenta, walls of the uterus and the sound and vibration of the mother’s voice. I know that my babies responded to me reading and singing to them by increasing their movement in utero, and studies show the same. Babies in utero typically have a faster heart rate when they hear their mother’s voice.

When babies are born, they are able to hear well, but not perfectly. The middle ear is still not completely mature and often babies have some fluid in the inner ear from the birth process, which affects their hearing slightly.  This slightly diminished hearing reception is why babies are able to hear higher pitches and frequencies better than other sounds. Incidentally babies prefer their mother’s voice to any other sound. This is both because of familiarity and because usually women speak in higher frequencies than men. What a great opportunity to use our voice to build those important connections in the brain. Simply by reading, singing and talking to our babies, we are stimulating brain cells and aiding in their motor and cognitive development.

Talk to baby to build important connections in the brain

Talk to baby to build important connections in the brain

Music is another great way to build those important connections. Because music is perceived with both sides of the brain, stimulating the corpus callosum (the neural fibers that connect the two sides of the brain together) a large part of the brain is stimulated while processing music, and the two sides of the brain start to learn to work together. This is important for motor skills, coordination, and higher level thinking and reasoning. Listening to music also helps babies comprehend and eventually speak language. There are a lot of similarities between music and language, no matter what language you are speaking, because of the variations in rhythm, tone, inflection, and volume. Babies’ brains are primed to respond to these aspects of auditory stimulation. Another really cool thing is that the areas of the brain that are responsible for language and music exist side by side, and develop with the same nerve pathway, so by exposing your child to music, you are also developing their language skills. Another cool anatomical thing about the brain is the mechanisms for balance are also housed in the inner ear, so auditory stimulation helps to develop your baby’s sense of balance as well. It certainly does not have to be Mozart. Any music will have the same effect, but studies have shown that more complicated patterns of music are more stimulatory to the brain. Just make sure it is music that you enjoy. Remember, your baby joins your family.

interact with baby as much as possible!

interact with baby as much as possible!

Tips for hearing development:

 

  • Read to your baby; encourage him to look at the pictures and help you turn the pages.
  • Provide as much music with varying sounds, pitches and rhythm as you can.
  • Sing to your baby as much as possible;
  • Help baby link two senses together by associating sound and vision. Allow baby to play with toys that also make noise, such as rattles and musical instruments.
  • Talk to baby often so that they learn to process language and begin to understand the flow of a conversation.
  • Use rattle booties and rattle wrist bands to help teach your baby body awareness
  • Encourage your baby to make their own noise by rubbing items together, knocking on surfaces, tapping their hands and feet.
  • Have other children talk to your baby. Babies are fascinated by children and their higher pitch voices are easy for babies to interpret.
  • Encourage your baby to babble and make sounds with their mouth. It is an early form of language.

It is important to note that although hearing is the best developed sense at birth, hearing loss is the most common congenital conditionin the United States. According to the American Academy of Pediatrics, an estimated three in 1000 infants are born in the US with moderate, severe, or profound hearing loss every year. Because of this high percentage, all states have implemented newborn hearing screens to be done in hospitals and birthing centers prior to discharge. Studies have shown that children identified with hearing loss prior to six months of age have a better chance of developing skills equivalent to their peers by the time they enter kindergarten. Children not identified until later may suffer from irreversible and permanent impairments in speech, language, and cognitive abilities.

mom and baby

Risk factors for congenital hearing loss include: babies whose mothers suffered from illness during pregnancy; babies who had a family history of hearing loss, or those who were exposed to drugs known to affect hearing; low birth weight and/or prematurity, or oxygen deprivation or breathing difficulties at birth; high bilirubin levels; syndromes associated with hearing loss; abnormal head or face structures; infections such as cytomegalovirus, syphilis, herpes; or low Apgar scores (test which assess several health factors at one and again at five minutes after birth).

  • Have fun with your baby’s wonderful sense of hearing, because as a mother of a thirteen-year-old, I can promise you, they won’t listen to your forever!

 

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How to teach your child to color outside the lines while teaching them to color in the lines.

The other day I heard a child expert say, “Teach your toddlers to be free thinkers, encourage them to color outside the lines.” Now, I am all for free thinking, I strongly encourage it even, but the occupational therapist inside me cringed, no shrieked! Can’t our toddlers be free thinkers, creative, and imaginative without compromising their fine motor and visual skills? I decided to shrug it off. Nobody would take that seriously, right? Later that same day a man said to me, “I am teaching my two-year-old grandson to color with both hands because I heard that will make him a better athlete.” Oh boy…

 

So let’s break this down…motor skills are emerging and fine tuning considerably in the toddler years and we need to encourage the development of these skills.  Hand dominance should be getting established and visual motor skills are being refined. It is so important to take every opportunity to foster these emerging skills.  Start by making sure your toddler is positioned appropriately, sitting at a child size table with their feet on the floor. You could also have them lie on their belly on the floor with good support through their forearms (this is a nice little trick for children with low tone or weak upper body strength). Because development occurs from head to toe and from the trunk of the body, outward, children will gain control over their shoulder movements first, then elbow, wrist and hand movements in that order. If you watch a toddler color you will notice that the whole arm is moving. The movement is most likely generated from the shoulder or elbow, while the muscles of the wrist and hand stay stationary, gripping the crayon. If you watch an older child color, hopefully their shoulder and elbow remain stationary while their fingers do the motion.  This doesn’t necessarily happen naturally, and it certainly doesn’t happen if we say “go ahead, color all over the page”.  Children need some direction and practice to refine these skills.

 

Here are some fun activities to practice basic coloring and handwriting skills: (A lot of these suggestions involve a sensory component, which helps engage the senses to memorize letter formation)

 

Write with fingers on a cookie sheet of shaving cream, flour, rice, or salt.

Write on a dry erase board or a chalkboard.

Write in the air with fingers.

Rainbow writing:  write a word and then trace it with different colors.

Q-Tips, chalk and water writing.

Use window markers or dry-erase markers on windows or mirrors.

Bath crayons in the tub.

Write with glue.

Use disappearing ink or invisible ink to write secret messages.

Sidewalk chalk on the driveway.

Use a paint brush and water on the driveway

Draw letters on your child’s back and have them guess the letters, then let them do it to you.

Make letters out of pipe cleaners

Make letters out of blocks or leggos or scraps of paper.

Write with spaghetti.

Have an older child teach a younger child how to write something specific.

Make gift tags to practice writing names and Happy Birthday, Merry Christmas, etc.

Write with a stick in the dirt or in sand at the beach.

Sensory salt tray with ginger and cinnamon.

Use a drawing app on a tablet and write words with your finger or a stylus.

Fill a ziplock bag with paint or hair gel and write with your finger.

Make birthday cards or holiday cards.

Write on a AquaDoodle or MagnaDoodle.

Bring crayons to restaurants to color on the back of placemats

Use paper table cloths and color during, before or after dinner

Roll out a roll on parchment paper on the floor and color on it to make wrapping paper.

 

 

Now, as for the free thinking, I strongly believe that toddlers are natural “free thinkers”. We don’t need to teach it, we just need to foster it and not inhibit it.  Children are inquisitive, imaginative, creative, and thoughtful. We just need to cultivate these qualities. While your toddler is coloring (in the lines) ask them thought provoking questions;  Why do you think birds can fly and cats can’t? Why is an apple red on the outside and white on the inside? Why do we keep ice cream in the freezer and not in the refrigerator? What would you do if you were on the moon right now?

 

Encourage questions and respond enthusiastically to their ideas. Build forts in the family room, encourage them to take chances, play make believe, play dress up, consider a wrong answer an opportunity, never criticize, respect your child’s opinions, encourage unstructured play, get messy, think mudpies, fingerpaint, shaving cream, make time for unstructured play, create an art center in your house with lots of fun supplies, make puppets, dance to loud music, encourage your child to disagree with you or come up with new solutions, and most importantly read to your child and limit screen time. With just a little bit of thoughtfulness and direction our children can be free thinkers and color inside the lines!

 

 

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Creative Easter Egg Hunts!

 

When your mom is an Occupational Therapist, you don’t get thy typical “candy in the plastic eggs” Easter egg hunt. We like to make it fun while at the same time, developing some type of skill.

Here are some ideas I have used over the years, both with my own children and nieces and nephews and in the clinic.

Exercise eggs:

Print out exercises from the internet or draw your own and cut them out and put them in the eggs. With a sharpie, write a number on each egg. For each egg they find, they need to open the egg and do that number of exercises that are inside the egg. They can do them all at once or one by one as they find the eggs.

Letter eggs:

Inside each egg, put a letter (either refrigerator magnets or letter cut outs or make your own on pieces of paper). After they find all the eggs, have them open them up and take out all the letters and see what words they can spell. Grade this for your child’s age. Maybe all they do is identify the letters, maybe they identify the letter, then write it in the air with their finger, or on a piece of paper, or with a wet paint brush on the sidewalk, or they spell out words. You can offer small candy rewards-it is Easter, after all. Maybe an m&m for each word.

Number eggs:

Inside each egg, put a number (either refrigerator magnet or number cutout or make your own on pieces of paper). After they find their eggs, have them open them up and take out all the numbers and identify them, then sequence them. Then put out a number and have them count out that many plastic Easter Eggs. Like the letters, you can reward with small pieces of candy.

Sensory egg hunt ideas:

For small simple egg “hunts” with toddlers or children with sensory impairments, hide eggs in big tubs full or rice or beans or small pasta or even Easter egg grass. You can also hide eggs on the beach in the sand, or under piles of freshly cut grass.

Glow eggs:

Put a glow stick inside each egg and hide the eggs in a dark room. This is a fun way to challenge your child’s visual motor skills!

Memory egg game:

After all the eggs are found, make a memory game out of them. Hide pairs of matching pictures under the halves of the plastic eggs and have your child look under two eggs at a time, trying to find a match. This will test their memory and matching skills.

There are lots of fun ways to hide those eggs that don’t involve candy!

Happy Easter and Passover!!

 

 

 

 

 

 

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Let’s play the retro way!

This post is in honor of a dear friend of mine who just adopted a baby and I would love for all new parents to adopt her simple philosophy of caring for her baby. Never knowing for sure if an adoption is going to go through, my friend was hesitant to do all the traditional rituals of having a baby shower, buying a layette, filling her home with baby gadgets, etc., so when the baby suddenly came into her life, many new parents would see her as “unprepared”. Her home is not equipped with swings, vibrating chairs, changing tables, exersaucers, johnny jumpers, Bumbos, Boppys, activity mats, play yards, baby monitors, pack n play, crib, bassinet, bedside sleeper, mobiles, gliders, (and the list could go on and on). Very simply, her “gear” consists of two things. Car seat and moby wrap; will travel. I love it! Are you worried that this sweet baby is under-stimulated? Quite the contrary. This baby is perfectly stimulated by movement in the moby wrap, simple tummy time and her mother’s voice, singing, talking and reading to her. That is all a healthy newborn needs!

This scenario makes me think of another good friend of mine, Dr. Anne Zachry, PhD, OTR/L, an Occupational Therapist who recently had a book published by the American Academy of Pediatrics. Dr. Zachry’s book is called Retro Baby and it puts into writing exactly what I try to teach through Aimee’s Babies. When it comes to newborns, less is more.

Retro Baby

It is estimated that the average new parent spends between $9,000 and $12,000 on baby related products in the first year alone. Baby products are a multi-billion dollar per year industry and it preys on such a vulnerable customer! New parents who just want to do right by their baby.

Babies are born with approximately 100 billion neurons in their brain, which will grow 1,000 trillion connections over the next three years. These connections mean greater potential for learning and these connections are directly related to life experiences, but we do not need every expensive light-up toy on the market to make these connections happen. We simply need to provide all babies with good nutrition, language exposure, strong emotional connection, touch and movement.

If you have read my column before, you know that I am generally opposed to some baby gadgets that can ultimately do more harm than good. We have so many babies in therapy now with developmental delays related to limited movement from spending too much time in carseats, bouncers and swings, that we have a term. Container babies. Container babies often have flat spots on their heads, poor neck strength and muscle control and delayed visual skills.

Think back to basics. Keep it simple. Tummy time, simple red, black and white toys, sock puppets, music and books. Sing, read, and dance with your baby. Think baby massage, paddy-cake, finger play, nursery rhymes, toes in the grass or sand, water play, peek-a-boo, homemade rattles, beach balls, and good old fashion balls and blocks.
There are so many ways we can take a little bit of time and stimulate our babies without over-stimulating our babies! You will save a ton of money, have a lot more room in your house, and your baby will thank you later.

Enriching vision skills with a deck of cards!

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Building confidence from the ground up.

Baby in supported sitting by momma

Around the age of six months babies hit a huge milestone that they will continue to do every day, sometimes for several hours a day, for the rest of their life…sitting.

They look so adorable when they sit there unsupported, tiny legs straight out, hands splayed out on the floor infront of them, taking in the world from a whole new vantage point.  Notice I said unsupported. That is the sitting I am talking about. Babies can sit much sooner than they can actually sit. Mommies and daddies can plop babies on the floor or in a sitting device where the baby can hold themselves in a static sit, then topple over or slump to the floor as soon as their weight shifts. In my opinion, this static sitting or “placed sitting” is counterproductive. Why do we spend so much time promoting movement and baby exercises when as soon as the baby has a little bit of trunk stability and mobility, we prop them into a sitting position that they could not get into on their own and they have no idea how to safely get out of? Let’s just wait until babies can get into a sitting position on their own!

When babies are safely able to transition into a sitting position on their own, we call that dynamic sitting or functional sitting. When babies are functional sitters they are able to go from their belly or crawling to sitting on their own and they know enough about how their body works to get out of the sitting position when they are ready. They are able to twist and turn and reach to the left and right while in sitting without toppling over. They can turn and look around and reach out and pick up a toy and play with it while still in the sitting position, then transition back to crawling or scooting when they are ready to move along.

This baby is able to rotate in sitting to reach for toys.

Babies learn to be functional sitters from repeated attempts to get into this sitting position on their own and lots of practice with supported sitting on parents’ laps. Supported sitting and tummy time help to strengthen trunk muscles to gain that important balance and trunk stability for sitting.

Babies who are plopped in a sitting device or propped with pillows in a sitting position are not really learning to sit because they are not getting any practice with the movements necessary to learn balance and control. Functional sitters who learn to get into that position by trial and error have learned and practiced the skills necessary to control their bodies in those transitional movements, making them safer and less prone to injury.  Functional sitters also have better body awareness, coordination and confidence because they know where they are and how they got there, reducing anxiety and increasing their sense of independence.

Please note that this independent transition to sitting resulting in functional sitting doesn’t typically happen until seven to eight months, whereas placed sitting occurs closer to six months. At six months continue to give your baby lots of movement, mobility and activity, including tummy time (up to 50% of their awake time) to build a strong core, shoulders, hips and neck.  Allow them tons of time on the floor to explore, use their gross and fne motor skills and develop strength and visual skills. It is also important to remember to sit your baby upright in your lap for balance practice and cuddles, but try to avoid placed sitting. Let them MOVE!

This is a great way to support your baby, encouraging eye contact and toys!

So I hate to bash another plastic item in the baby product industry, but please let’s not use the “baby sitter-uppers”,

let’s just wait and let our babies learn to sit up on their own!

 

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Preparing for Preschool

As summer winds down a lot of little ones are focusing on some very specific goals so that they can be ready to go to preschool. Taking that big step to prepare to spend a few hours away from mommy and daddy can be huge. Just the stress of being completely potty trained alone is enough to put some three-year-olds over the edge!

Here are some tips that can help prepare both you and your toddler for that big first day:

In the weeks before school starts:

Read to your child

Reading to your child is so important for building literacy and instilling a love of reading in your child. Use your finger to follow the words so they understand those symbols really mean something. Ask your child to “read” to you once they know the story.

Play Preschool

Act out school at home. Do story time with stuffed animals. Act out standing in line and raising your hand and sitting at a table for snack time. Talk about what to expect and always use a positive, upbeat attitude!

Practice self-help skills

Children are not expected to be completely independent on the first day of school, but it will help your child feel more confident if they can at least attempt to put on their own coat, zip up their backpack, and tie their shoes.

Visit the preschool

Both you and your child will be more relaxed on the first day if you can visit the school and meet the teacher in advance. You can learn where to park and where to enter the school. Show your child where she will hang her backpack, where she will sit, where the bathroom is and point out the fun toys and activities that are there.

Buy all the right supplies

Make sure you buy your child a small backpack, clothes that are easy for them to pull up and down and good sneakers for the playground.

The day of the first day of preschool:

Make sure your child has a good night sleep and a good breakfast

Start the school bedtime at least a week before school starts so children are well rested and in the habit of going to bed earlier and waking up earlier in the morning. Your child may have first day jitters but a healthy breakfast is still really important.

Come up with a fun goodbye ritual

Maybe it’s a high five or a special hug or kiss, but a goodbye ritual will make your child feel reassured and comforted. If they are nervous about you leaving, maybe you give them something to hold on to, like a sticker that you kiss then place on the back of their hand.

Plan to stay for a few minutes

Hang out just for a few minutes until you see that your child is comfortable. This will make both of you feel more relaxed when you leave.

The first day of preschool is such a huge milestone! Remember to praise your child for their bravery afterwards and maybe celebrate the first day with a special dinner or trip to someplace fun, but remember they will be tired and maybe a little cranky, so your big preschooler may need a nap more than ever!

My daughter's first day of preschool tip: Make sure the sun is not in your child's eyes when you take that picture!

 

 

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Repetitive sports injury prevention

The cutest soccer team in the league

Cute, right? Who doesn’t love to watch three and four year olds run around on the soccer field or t-ball diamond. Some of them giving it their pre-schooler “all” and some of them chasing butterflies.

This time of year I am reminded of how young we start our kids in organized sports and how the level of intensity seems to grow every year. As my one daughter goes from year-round tennis conditioning to year round tennis clinics and my other daughter finishes her swim team season, just to be pressured into signing up for the fall indoor swimming league.  I made the mistake a few years back of allowing my daughter to do three sports that all overlapped. I didn’t realize they would overlap when I signed her up since one was a winter sport, one was a spring sport and one was a summer sport, but seasons are growing longer and longer.

I bring this up because as a mom, an OT and an athlete, I have concerns. Only in America are kids so sports specific at such an early age.  The American Academy of Pediatrics (AAP) recommends that children wait until at least age six to start organized sports because before age six, they typically do not really understand the concept of teamwork and young children should be spending their time engaging in free play.  I think that if a young child wants to be a part of a team, there are tons of benefits to it as long as they don’t feel pressured or physically overextended, but like everything, moderation is key.

Because sports seasons are growing longer, travel teams are growing in competitiveness and intensity, and most sports have year-round opportunities, it is more important than ever to protect our kids from repetitive use injuries. Ten-year-olds are blowing out ACL’s, dealing with tendonitis, and stress fractures…injuries that should not happen to athletes until they are playing at the college level.

I think precaution and variety is the key. Precaution, meaning take measures to keep their bodies safe. Work on stretching, breathing and strengthening. Yoga is a great foundation for any sport. I have trained for and run a few half-marathons, marathons and triathlons and for me, yoga is key to staying healthy. I also need to change up my routine from time to time to avoid certain strains of over-used muscles. Variety is so important. I think young kids should be a part of two or three different sports per year. When young kids become sports specific by age nine and spend all year doing just soccer or just field hockey, for example, they are much more prone to repetitive use injuries from these sports. Their bodies use the same muscles, tendons and ligaments and are never given ample time to repair or to strengthen complimentary muscles and skills.

The AAP makes several recommendations to keep our young athletes healthy. This is from their 2014 Sports Injury Prevention tip sheet:

  • Time off. Plan to have at least 1 day off per week from a particular sport to allow the body to recover.
  • Wear the right gear.  Players should wear appropriate and properly fit protective equipment such as pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and/or eyewear. Young athletes should not assume that protective gear will protect them from performing more dangerous or risky activities.
  • Strengthen muscles. Conditioning exercises during practice strengthens muscles used in play.
  • Increase flexibility. Stretching exercises before and after games or practice can increase flexibility. Stretching should also be incorporated into a daily fitness plan.
  • Use the proper technique. This should be reinforced during the playing season.
  • Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.
  • Play safe. Strict rules against headfirst sliding (baseball and softball), spearing (football), and body checking (ice hockey) should be enforced.
  • Stop the activity if there is pain.
  • Avoid heat injury by drinking plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during high heat/humidity periods; wear light clothing.

– See more at: http://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Sports-Injury-Prevention-Tip-Sheet.aspx#sthash.JV2ZTe3p.dpuf

The AAP also warns against emotional stress for our young children. Make sure they are on a team where the coaches, parents and other players value the game and the experience and the teamwork over always winning. Check in with your kids; however young, about their emotional experiences related to their sport.

Take a few precautions and young sports teams can be a wonderful thing. Good exercise, camaraderie, time outside, and self esteem are only a few of the many benefits.  Just remember, variety, moderation and proper precautions!

 

 

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Celebrating OT month- Just under the wire!

I’ve been MIA from my blog for a while. Come to think of it, I’ve been MIA from everything for a while. I started a new job as director of pediatrics at a new out patient rehab and I also took on a new creative endeavor. I directed 72 ten and eleven-year-olds in a musical at my daughter’s school  It was fun and thrilling and exhausting and exasperating all at the same time, but as I always love a new challenge and always need a creative outlet, I really loved every minute of it.
Anyway, I am back to my blog, just in time to acknowledge my beloved profession on the last day of the month set aside to spread awareness about our wonderful profession.  My experience as “director” has actually given me lots of thoughts about occupational therapy.

I graduated with my degree in OT from Misericordia University in 1996 with a great job already lined up and that thrilling sense of adventure you feel when you’re starting something new. Here I am, eighteen years later with that same feeling of excitement about being an occupational therapist. Not only because it’s April, but because it is such a diverse field, we can re-invent our job on a daily basis!

A lot of people feel that the name “occupational therapy” does our profession a disservice. I am often explaining that we do not find jobs for people, or come help people at their work place. The word occupation refers to a person’s daily living and the roll of an occupational therapist is to use treatments to help people develop or recover their daily living skills if they have a physical, mental or developmental disability. So daily living skills can encompass so much! Think of all you do in a day and imagine if you had an accident or condition that prevented you from doing everything you do. Enter occupational therapist! We help babies with developmental delay learn to roll over, crawl, suck from a bottle, take their first step. We help children in school learn to color, write, use scissors, tie their shoes. We help adults get back to work, cook, drive, re-visit the hobbies they used to love. We help elderly get dressed, walk with a walker, push their own wheelchair, and use a cell phone to call their grandchildren. Our work spans a lifetime and I am constantly renewed by the diversity occupational therapy offers. Because we work everywhere from neonatal intensive care units, to schools, to psychiatric hospitals to nursing homes, it’s like we can have a whole new profession every time we switch jobs.

I love how OT was started. It truly was born out of necessity. The early roots were in 18th century Europe during the Age of Enlightenment when they switched from chains and restraints to more humane treatments, utilizing leisure and purposeful activity. In the early 1900’s in the United Stages, well-intentioned women helping with the war movement practiced OT without even knowing it, as they helped the young wounded men who returned from war. They thought they were playing simple games, doing arts and crafts, and taking wounded soldiers for strolls through the gardens to lift their spirits and take their mind off their injury, but these activities (occupations) were healing them mentally and physically. The profession of occupational therapy was officially named in 1920.

Musical theater is a passion of mine and I have actually used it quite a bit as a therapist. I have taught psychiatric patients to play instruments and sing to organize their thoughts and improve their attention. I have used rhythm and dance to help young children improve their motor skills. I organized a special needs class of children with mental and physical disabilities to perform a full play. They made the scenery, learned lines, (those who were non-verbal pressed buttons to deliver pre-recorded lines) and they used props that they made with their own hands (hand over hand if need be).

As I ran from my job as an OT to musical rehearsals, I couldn’t help but to think it felt consistent with what I do as an OT. I watched these children develop an incredible sense of confidence as they found their voices on the stage. As we worked on diction exercises I noticed one little boy’s speech impediment improve and as we ran dance numbers again and again I saw improvement in children’s coordination and motor skills.

There are opportunities for improving our skills through activity or occupation everywhere!

I became nostalgic for my profession when my co-director and I were struggling to carry a heavy 1920’s style wheelchair we needed for a prop up a flight of stairs. Just the day before that, I taught a family how to drive their child’s motorized wheelchair up a state-of-the-art ramp to their house. That cumbersome antique wheelchair reminded me how far my profession has come. From 18th century Europe, to early 1900 wartime, to today OTs have touched a lot of people and improved a lot of lives and I am so proud to be a part of it!

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A look “Beyond the Label”

In the 10 years I have spent as an education-based occupational therapist, I have gained an incredible amount of empathy for parents and children who suddenly have a “label” attached to their name. Parents are often left reeling with the realization that their child will require ongoing special accommodations to help them to reach their full potential.  It can feel overwhelming to step in to the role of advocate, when many are dealing with an intricate system that is not fully understood.

I was recently given the opportunity by Karen Schiltz, PhD to review her book, Beyondthe Label, A Guide to Unlocking a Child’s Educational Potential. Dr. Schiltz has a private practice in pediatric neuropsychology and 25 years of experience assessing children with attention, memory, behavioral, and learning difficulties. She co-wrote the book with clinical psychologist, Amy M. Schonfeld, PhD, and Tara A. Niendam, PhD, assistant professor at the UC Davis Department of Psychiatry.

I found Beyond the Label to be a very practical, informative, and thorough guide. The information it contained is applicable to teachers, school administrators, parents, therapists, and anyone who is involved with helping a child with special accommodations be successful in school.

The book is divided into three parts. Part One encompasses the fundamentals of educational law including: What is the IDEIA?, What is an IEP? What is a 504 Plan? Additionally, this section also covers assessments, modifications and accommodations. Finally it introduces the team of professionals who will be involved with the child. I was happy to read that Dr. Schiltz was completely accurate in describing the roll of the occupational therapist!

Part Two explores the process of recognizing, assessing and accommodating the child’s challenges, whatever they may be.   Dr. Schiltz uses realistic clinical case studies and scenarios from the point of view of the child, the parents and the teacher in some instances to help illustrate potential delays that would affect a child’s ability to perform in school.

I was particularly pleased that the time was taken to present entire chapters to each of the following issues: Attention and Concentration, Memory, Executive Functioning, Language, Visual Perceptual Ability, Visual Processing Speed, Achievement, Emotional Functioning and Social Skills.  Dr. Schiltz explains how each of these components is integral to learning. She explains what the weaknesses in each area might look like. There is explanation given as to possible causes, how to accommodate and how to treat the child in the school environment and beyond.  I particularly appreciated the separation of the chapters on visual perception and visual processing. They are two very different issues, originating from two separate areas of the brain and must be addressed independently. Additionally, each chapter explains the difference between a minor delay and a “big problem” and also provides specific recommended accommodations and test taking strategies, even for SATS and other college level tests. These chapters in particular, will be very helpful to parents and students.

Part Three pulls all the information together, and focuses on the “big picture”.  This section refers to each child’s unique set of challenges as their “roadmap” and discusses the importance of understanding your child’s roadmap, to best facilitate their individual learning needs. As a therapist, I love this. I stress treating the child as a whole.  I do not just address fine motor skills, or short term memory. Everything builds on everything else and it is so important to keep the big picture in mind. This section also emphasizes that “knowledge is power!” Indeed it IS. That understanding is the foundation of Aimee’s Babies. When parents and caregivers know better, we do better. We need to know our child’s individual strengths and weaknesses and inform ourselves on development early, so we can be vigilant and be a proper advocate for our child in every situation.

The book concludes with a beautiful, real-life success story about a young woman named Diane.  It truly illustrates that with the proper knowledge, assessment, intervention, and accommodation, success is an attainable and realistic goal! That is what I have dedicated my life to, and I hope others will recognize this possibility as well.

Finally, the book provides appendices of lists for classroom such as test accommodations, assistive technology resources, and websites that provide additional information.

I am often asked to review books or DVD’s, and when I am finished, I usually pass it on to someone who might have more use for it, but this book is going on my bookshelf. It is already ear-marked, highlighted and annotated. As I read through it, I thought of several of my past and present students and their families.  This book is a fabulous resource for many students, parents, therapists and teachers as it provides everything from basic information to specific treatment techniques. I am pleased to have it as a part of my personal library.

 

 

 

 

 

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