Travel Tips: “My Child Needs To Move!”

Thursday, July 17th, 2014


Road trips with children are challenging. Road trips with children who seek movement can be even more challenging because they need to sit still and stay belted during the car ride. Use rest stops to your advantage. Whether you’re breaking to fill up on gas or to use the restroom, allow your child/ren to get out of the car and encourage them to move.  Here are some movement ideas:

  • Stretching
  • Jogging around the building (if there is a sidewalk)
  • Running in place to a fast-paced sound
  • Jumping jacks
  • Hop, skip or gallop back to the car

Consider making a pack of “Get up, get out and move” cards before your trip with funky movement activities, including yoga poses, animal walks, races and break dancing. Shuffle the deck of cards and let each child pick up 1 card per rest stop.

Submitted By: Aviva Goldwasser, MS, OTR/L, and Chaye Lamm Warburg, DPR, OTR/L

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This entry was posted on Thursday, July 17th, 2014 and is filed under Autism, Infants & Toddler Tips, Parenting, Seasonal Tips, Sensory Integration, Sensory Processing.

Summer Safety

Wednesday, June 5th, 2013

In my 22 years as a lifeguard, most rescues I have made were of children within a few feet of a parent, or even holding their hand! So, before the swimming season starts, take a few minutes to familiarize yourself with what drowning looks like with this article from Slate. You may be surprised. 

Enjoy the summer and stay safe!

This entry was posted on Wednesday, June 5th, 2013 and is filed under Infants & Toddler Tips, Infants & Toddlers, Parenting, Seasonal Tips.

The Importance of Touch for Babies

Wednesday, April 17th, 2013

  1. Touch is Calming and Alerting: One of the first ways we relate to our babies is through touch. Certain types of touch calm our babies and other types of touch are alerting. Both calm states and alert states are important for babies at different points of the day. Deep and even pressure, such as a massage is calming, while light tickling is alerting. Providing your baby with a variety of touch experiences will enhance their ability to process touch sensation and respond appropriately rather than over- or under- responding. Examples of appropriate responses to touch are a child turning to someone who taps them and enjoying playing in a sandbox or with Play-Doh. Inappropriate responses are flipping out when being tapped on the shoulder or avoiding standing on line (over-responsive) or accidentally bumping into walls and other people (under-responsive).
  2. Touch Teaches Babies about their Bodies: Ever notice how newborn babies move their arms and legs randomly, and often in a jerky manner? This is because they have not yet learned how their body parts are connected or how to control them. As babies develop they gain control over the different parts of their bodies and move them in an increasingly fluid way. Ultimately they turn into toddlers and young children who can master playground skills and sports. All of these skills start with body scheme and body awareness. Touch plays an important role in developing body awareness. As babies are handled and stroked they learn where their knees are in relation to their feet and how their hands are connected to their arms.
  3. Touch Tells Babies about Proximity: As a babies experience touch, they begin to sense the limits of their bodies and understand where their body-ends and another begins. This allows a child to sense how close or far away people are. Why is sensing proximity important? In order to tolerate being in a crowded environment, a child must accurately perceive how close and far people are. Navigating within the environment without bumping into people and objects also requires a sense of distance. Just as we need experience to learn the size and boundaries of a car when learning to drive for the first time, a baby and child needs tactile experiences to learn the boundaries of their bodies in order to navigate efficiently in the environment.

Some ideas for tactile play:

  1. Give your baby an infant massage. Check out our infant massage blog here. Join our Parenting Boot Camp for an introduction to infant massage on Sunday, April 21. Check it out here  or on Facebook.

  2. Let your baby immerse his/her hands in food

  3. Encourage “messy play,” such as sand, finger paint, Play-Doh and glue

  4. Have toys that are a variety of sizes, shapes and textures

  5. Use bath time to introduce sponges of different textures, splash in the water and play with funny foam and tub paint.  Hide foam stickers on your child’s body and ask him/her to look for them.


This entry was posted on Wednesday, April 17th, 2013 and is filed under Infants & Toddler Tips, Infants & Toddlers, Parenting, Uncategorized.

Infant Massage

Monday, March 11th, 2013

A few weeks ago I took an infant massage course with certified infant massage (IM) instructor and physical therapist Esther Perl. Now infant massage is my favorite activity to do with both my 5-month-old and 3-year-old!  Aside from the obvious fact that baby skin is simply delicious, here’s why I love it:

For Baby (& Mommy):

Communication: Massage gives us a few minutes to strengthen our back and forth communication. Babies are always “talking” to us, and not only by crying. We just need to tune in. When massaging my baby I learned to notice and respond to his subtle cues. He coos, smiles and relaxes his body when he enjoys something and looks away, stiffens a limb or arches his back when he’s had enough. Initiating and responding to non-verbal communication is a vital social skill that starts developing in infancy.

Tactile Processing: The touch and deep pressure of massage strokes activate receptors in the skin that help regulate the tactile system. The tactile system plays an important role in accurately interpreting information from the environment and in developing body awareness.

Body Awareness: Pairing the massage of each body part with language (i.e. Singing “this is the way we massage the tummy, massage the tummy…”) heightens body awareness on the cognitive level well as subcortically. Accurate interpretation of information from the environment together with body awareness sets the stage for precise motor control.

I watch in amazement as my baby gets used to different types of touch and learns more about his body from week to week.  Now, when I complete a leg massage, a little foot wiggles in my face asking for its turn!

Calming and Organizing: A gentle voice, even strokes and deep pressure are relaxing and organizing for a baby. Babies crave calming input, especially after an eventful day of experiencing new sights, sounds and movements.

For Preschooler (& Mommy):

A Bedtime Miracle: The first time I tried IM on my preschooler, she fell asleep within 5 minutes instead of the usual one hour to fall asleep, so I considered this pretty miraculous. While this level of drama has yet to repeat itself, bedtime has become a calmer more special time, and less of a power struggle. Just the mention of massage during her bedtime routine gets my daughter relaxed.

Bonding: Preschoolers often test the limits, sometimes all day long. No matter how many battles have ensued, my daughter and I get to bond and appreciate each other during massage. It’s a great opportunity to calmly talk about the day and whatever else is on her three-year-old mind.

Decreasing Tactile Defensiveness: As mentioned previously, deep pressure helps to regulate the tactile system.  Children who are hypersensitive to touch, avoid proximity to other children and resist clothing textures, tags and seams are more comfortable when they are massaged regularly.

Ariela Harcsztark OTR/L

This entry was posted on Monday, March 11th, 2013 and is filed under Infants & Toddler Tips, Infants & Toddlers, Parenting.

Maximizing Changing Table Time

Monday, January 14th, 2013

Babies need a diaper change as often as 12 times a day. That’s 12 great opportunities to bond with your baby and have a blast, all while fostering communication, body awareness, motor skills and play. Here are some tips on how to make the most of changing table time:

Smile and Sing
When you change your baby’s diaper, you are at the perfect distance to gaze lovingly into each other’s eyes.  At 4-6 weeks old, use this opportunity to work on eye contact and eliciting a social smile. There is nothing more satisfying than that big toothless grin! Babies can imitate faces as early as the first two days of life, so go ahead and stick out your tongue. As your baby gets older, make back and forth cooing sounds. This will lay the groundwork for eventual back and forth conversation. Singing about all the things going on around you is a great way to engage your baby (and entertain yourself). For example: “This is the way we change the diaper, change the diaper…” As your baby develops the ability to make new sounds he might “sing” along.

Touch and Tickle
Babies love to be touched. Take a minute to give every little part of your baby’s body some attention. You can give a baby massage, tickle and blow tummy raspberries. This will develop his tactile system and help him map out his body to heighten body awareness. It also gives you the opportunity to learn what type of touch your baby prefers and where his ticklish spots are. “Head, shoulders, knees and toes” is another great song for developing body awareness.

“Clap, Clap, Clap your Hands”
Gently hold your baby’s wrists and bring his hands together to “clap” while singing “clap, clap, clap your hands.” This will help your baby develop the ability to bring both hands to the center of the body, a skill that should develop at 3-5 months old. You can also hold both hands and ask, “How big is the baby?” Say “soooo big,” as you raise his hands over his head.

“The Wheels on the Bus”
Sing “the wheels on the bus” while holding your baby’s feet and match leg movements to the song. For example, open and close his legs as you sing “the doors on the bus go open and shut.” Seeing and feeling his legs move might encourage your baby to reach for his knees and his feet, and maybe even stick his feet in his mouth. Games where arms and/or legs are moving symmetrically and asymmetrically helps to develop bilateral coordination and build body awareness.

Be Ridiculous
When you are changing your baby you have his full, undivided attention. Here’s your chance to be the entertainment while teaching your baby how to play some new games. The more animated and ridiculous you are, the more you will pique your baby’s interest. Play peek-a-boo using the diaper to cover your face and make silly faces when you remove the diaper. Play “where is the diaper” and put the diaper on your head. Through these games your baby eventually develops object permanence.

As babies get older (around 6 months old), they become less interested in taking a break from play for diapering. They might strongly resist diaper time, turning the changing table into a battleground. By making changing table time an exciting bonding activity, it becomes an activity you both look forward to instead of dread.

Submitted by: Ariela Warburg MS, OTR/L & Dr. Chaye Lamm Warburg, DPS, OTR/L, Director of P.O.T.S.

This entry was posted on Monday, January 14th, 2013 and is filed under Infants & Toddler Tips, Infants & Toddlers, Parenting.

Cardboard Boxes = Endless Fun!

Wednesday, December 12th, 2012

In this article from Gawker via Ohio’s NBC4, preschool teacher Pete Kaser had the novel idea to switch from his classroom’s name brand toys to cardboard boxes.

This article goes to show that children can use anything as toys–they do not require brand names, cartoon characters, etc, just basic “open” toys–those are items, like balls or boxes, that do not demand a specific action, but allow the child to use his imagination and use them in a multitude of ways (the toy does not constrain or place limits on the player). What’s interesting to us is that this is news! What do you think? Would you incorporate a cardboard box into your child’s playtime?

This entry was posted on Wednesday, December 12th, 2012 and is filed under Infants & Toddler Tips, Infants & Toddlers, Parenting, POTS Favorite Toy Ideas, Uncategorized.

What is My Baby Telling Me?

Friday, November 30th, 2012

When I became a new mommy, nothing drove me crazier than having no idea why my baby was crying. Was she hungry? Tired? Gassy? Why didn’t she come with a manual?! Like many mothers, I found myself (at 3am) trying everything I knew and seeing what stuck.

All newborns communicate by crying, but how do we know what they are trying to say? I got an answer to this question when watching a YouTube clip of a Priscilla Dunstan interview on Oprah Winfrey, admittedly not my usual source of parenting advice. Australian mom Priscilla Dunstan claims that babies cry differently depending on what is bothering them, and if we train our ears to differentiate between the cries, we can figure out what it is our babies are trying to say!

The following are the 5 sounds that babies use to communicate their needs:
“Neh” is the sound that means hungry. When babies are hungry they suck reflexively. The resulting sound is produced by tongue touching the roof of the mouth.
“Owh” means tired, because babies make an “O” shape with their mouths when they yawn.
“Heh” is the sound associated with discomfort.
“Eair” is the sound produced when the lower abdomen contracts and the baby breathes out. This signifies gas pain.
“Eh” means the baby needs to burp.

This discovery was exciting, but I soon learned that it is not so easy to distinguish between the sounds. “Eh,” “Heh,” and “Neh” sound an awful lot alike. It takes a lot of focus and a bit of trial and error to learn your baby’s sounds. Once I trained my ears, I discovered that the effort paid off. See the following before and after scenarios: These really happened!

Baby: crying her head off
Mommy: changes baby’s diaper
Baby: crying her head off
Mommy: tries to feed the baby, but she doesn’t want to eat
Baby: crying her head off
Mommy: crying her head off

Baby: “Neh”
Mommy: feeds baby
Baby: “Eh”
Mommy: burps baby
Baby: “Owh”
Mommy: swaddles baby, gives a pacifier and walks the baby to sleep
Baby: sleeping
Mommy: happy

Hear for yourself on YouTube.

Submitted by: Ariela Warburg, OTA
& Chaye Lamm Warburg, DPS, OTR/L, Director
Pediatric Occupational Therapy Services

This entry was posted on Friday, November 30th, 2012 and is filed under Infants & Toddler Tips, Infants & Toddlers, Parenting.

TUMMY TIME, a How-to Guide

Thursday, November 1st, 2012

I am happily the grandmother of two brand new babies, now ages 1 week and 4 weeks. My daughters came home from their respective pediatricians with the expected admonition that they are to keep those babies on their backs for sleep, but not to forget to do “tummy time.” No explanations. No timetable. No details offered.

My daughters, like many new mommies, tentatively put their babies on their tummies, could not bear the inevitable crying, and quickly rescued their babies by picking them up or flipping them on their backs. Logically, they surmised that the baby was not “ready” or “old enough,” or that they were unduly causing distress. But when is a baby “ready?” How much apparent discomfort should a baby have to tolerate. When do the benefits out-weigh the crying?

My occupational therapist daughter, understanding the consequences of no tummy time (yet delaying initiating it nonetheless….), torticollis, plagiocephaly, delayed head control, rolling and other first year milestones, plowed ahead despite her baby’s crying, keeping him on his tummy several times a day. My daughter-the-attorney did not have a clue as to what “tummy time” was. How could she? Luckily she had two role models in her mother and sister to initiate tummy time as soon the baby’s umbilical cord fell off, as per her pediatrician’s request. At 9 days she moves her head from side to side, albeit slowly, both when awake or napping. She is on her tummy 5-6 times a day when vigilantly watched by her mommy, daddy or a plethora of other doting relatives.

There are many ways to get your baby used to tummy time. Practice during your baby’s awake time, several times a day, for 2-3 minutes at first, a soon as soon as your pediatrician will allow. Lengthen tummy time as soon as you can. Simply lay your baby down on your tummy (easy; nicely contoured), lay him/her on your lap or on a play mat (harder surface; more challenging). Distract him/her with eye contact, cooing and eye-catching toys with high contrast (such as black and white) or a mirror. You will be amazed at how quickly your baby will first turn his/her head slowly from side to side, raise it steady, and eventually prop on her forearms and then hands. Celebrate each mini-milestone and know that you are facilitating your baby’s development in a meaningful way.

See the attached article for tummy-time details.
Feel free to post your ideas for facilitating tummy time!

Tummy Time For Beginners

This entry was posted on Thursday, November 1st, 2012 and is filed under Infants & Toddler Tips, Infants & Toddlers.