A guide to the perplexed: 6 tips on how to be a great therapy parent.

Friday, March 2nd, 2012

Many parents are unsure of how to maneuver through the world of therapy. Since there is no rule-book for parents (as far as we know), listed below are some guidelines that we feel would be helpful for you to maximize the benefits of occupational therapy. 

  1. Keep your therapist in the loop.  P.O.T.S. therapists want to collaborate with parents to ensure the best outcome for all children. In order to do so most effectively, therapists benefit from knowing what is happening outside of therapy, in the real world. Information about how your child is coping with expectations at home, school, play dates, after-school activities, birthday parties and homework helps us target underlying skills for intervention, judge the efficacy of our treatment and provide suggestions for home. We also love how to hear about your child’s successes and accomplishments, and how therapy has impacted on his/her life.

 

  1. Ask questions. Parents need a solid understanding of what is challenging for their child and how therapy can help. If you received an explanation, but the concept remains elusive, we will happily explain it again, and again.

 

  1. Choose your spot. Because the waiting room is a difficult place to conduct a conversation, and it is often counter-productive to have discussion with the child present, feel free to contact the therapist by phone or email ahead of time if there is something the therapist should know before the session starts.  Similarly, feel free to ask questions by phone or email after the session. The therapist will get back to you as soon as possible.

 

  1. Sitting in on sessions.  Often parents are uncertain whether or not to sit in during their child’s treatment sessions. Take your cue from your child. If your child is able to function as if you are not there, it can be very productive for you to observe, take notes, and implement the strategies you learn at home. However, if your child distracted by your presence or changes his/her behavior, it may best if step out of the session. If you are out of the room, you always have the option of observing through the one-way mirror in the door. Do come in for the last 10 minutes of the session so that the therapist can update you on your child’s progress and upgrade your home program.

 

  1. Home programs.  When your child’s therapist provides you with a home exercise program or sensory diet, please give him/her feedback about what is most easily implemented, and what strategies have been the most effective.  Do let him/her know if she is over-loading you, not providing enough suggestions or not targeting key points in your day. Remember, 5-7 minutes of “work” with your child a day is equivalent to one additional therapy session per week. Home programs have to be updated frequently as your child makes progress and priorities change. 

 

  1. The team approach.  Encourage and facilitate communication between the professionals in your child’s life to capitalize on their collective expertise.  When professionals meet in person each has the opportunity to gain perspective on the total child, and understand his/her unique place in helping you and the rest of the team and achieve the goals you have identified as priorities for your child.  Parents, teachers and therapists will gain a deeper understanding of the child and have the opportunity to incorporate techniques and benefit from the suggestions that each party has to offer.  Maintain the channels of communication by allowing professionals to contact one another, if it is appropriate in your situation.  Successful venues for meeting have included school, a therapy office and the child’s home.  At P.O.T.S, teachers, ABA coordinators, speech therapists, physical therapists, aides and others have joined us for sessions, and those events are often turning points for all of those involved.
This entry was posted on Friday, March 2nd, 2012 and is filed under Parenting.

Updated Recommendations About Limiting TV for Children

Wednesday, October 26th, 2011

Do not be fooled by advertisements claiming that TV programs or video games are “educational”. About two years behind the French, the American Academy of Pediatrics has  just released new warnings about allowing young children to watch TV. “Screen time”, time spent in front of TVs, computers, and video games, offers no educational value to children under the age of 2. On the contrary, it detracts from the children’s  ability to engage in age appropriate play and explore  the environment.

The Numbers:

On October 18, 2011, the New York Times reported that a recent survey found that 90% of parents reportedly allow their children under the age of 2 to watch some form of media.

The Risk:

A recent publication in the journal Pediatrics estimated that for every 1 hour a child is exposed to media, 50 minutes less is spent playing with a parent, and 10% less time engaged in play.

Note that children under the age of 2 are in the midst of a critical period of language development. Children pick up and understand language best when it comes from another person, face-to-face.  They do not learn language from videos and TV.

The Recommendation:

While the American Academy of Pediatrics acknowledged that media is ubiquitous nowadays and many parents rely on screen time for a much-needed break throughout the day, it is incumbent upon parents to limit the amount of screen time children will be permitted.

Furthermore, parents are cautioned against leaving the TV on in the background, since it has been found that it is overly distracting to both children and parents.

This entry was posted on Wednesday, October 26th, 2011 and is filed under Parenting.

FAQ’S from the POTS Handwriting Without Tears Workshop

Wednesday, March 16th, 2011

On Wednesday evening March 9, 2011, POTS was proud to present an informative, hands-on Handwriting Without Tears workshop to parents and pres-school teachers. We introduced participants to a variety of multisensory materials and educated them on how best to approach teaching children how to write upper and lower case letters and numbers.

 Q: I am a preschool teacher. What activities are best for me to use with the entire class?

A: For 3 year olds, the best activities are those that teach body awareness and sense of body position in space through physical activity and hands on experiences. Mat Man is a great circle time activity that we demonstrated during the workshop to facilitate the development of a strong sense of one’s body parts and their relationship to each other. It also introduces children to the Big Line, Little Line, Big Curve and Little Curve that are the foundations of all capital letter formation. Simon Says is also a great way for 3 and 4 year olds to learn positions such as up, down, in front of, behind, etc. Building strong foundational skills at these young ages will facilitate successful writing later on.

Q: Why are the letters not taught in alphabetical order? 

A: The alphabet consists of 26 letters that are not all similar in appearance. For example, A is made up of two diagonal lines and a small line across while B is composed of a big line and two small curves. Developmentally, children do not learn diagonals and curves at the same time. Handwriting without Tears is a “kinesthetic” method teaches letters in a developmentally appropriate sequence and groups together letters that are formed similarly. A significant amount of time should be spent teaching the first letter in each letter group to establish a strong motor pattern. Once the child has a “feel” for the letter and the way it is formed, it will be much easier and faster for him/her to learn the subsequent letters in the group. For example, once C is well established, it is simple to learn letters such as O and Q. 

Q: I already use a lot of multisensory materials in my classroom- what makes Handwriting Without Tears a “multisensory” approach to writing? 

A: Using a variety of materials such as Play-Doh, foam, sand, etc. enables young children to explore their sense of touch. However, a writing program becomes multisensory writing when the approach to letter formation is targeted using a rich variety of sensory activities. The key is to ensure that each time the child forms a letter – in pudding or with a pencil- the approach is top-to-bottom and left-to-right and in the correct sequence. The goal is to facilitate purposeful letter formation by using multisensory materials to create a fun, effective way to learn.

For those of you who attended, we hope you enjoyed the workshop as much as we did, and we look forward to seeing you again at POTS.

 Blog written by: Aviva Goldwasser, MS, OTR/L & Dr. Chaye Lamm Warburg, DPS, OTR/L, Director of POTS

This entry was posted on Wednesday, March 16th, 2011 and is filed under Handwriting & Fine Motor Coordination, Parenting.

A Close “LOOK” at Developmental Optometry

Wednesday, February 9th, 2011

What is a developmental optometrist?

 A developmental optometrist is an eye doctor who has completed two to three years of post-graduate training and is credentialed as a Fellow in the College of Optometrists in Vision Development, or F.C.O.V.D.

Developmental optometrists may also be called a behavioral optometrists or pediatric optometrists because of their roles in evaluating the impact of vision on behavior and learning.

My child has good vision, how do I know if he/she needs to be evaluated by a developmental optometrist?

A child may have “healthy” eyes and not require glasses, but still have visual problems. In addition to performing routine eye exams, a developmental optometrist will complete other tests to determine whether the patient has adequate visual function in order to perform daily tasks, such as reading, focusing back and forth between a printed page and the blackboard, and catching a ball.

 Symptoms that may indicate a need for a developmental optometry evaluation:

Headaches while reading or writing

  • Blurry vision when reading
  • Difficulty smoothly reading across a line
  • Skipping words or entire lines when reading
  • Difficulty copying from the blackboard
  • Avoiding reading and writing
  • Poor reading comprehension
  • Short attention span
  • Moving one’s head excessively when reading
  • Poor handwriting
  • Burning, itching, or watery eyes
  • Bumping into things
  • Holding books too close or too far
  • Squinting
  • Difficulty recognizing faces

What areas of vision are assessed developmental optometrists?

Binocularity: the ability of the eyes to work together to transmit information to the brain

Oculomotility (tracking): the ability to smoothly and accurately move the eyes, which is especially important for reading

Accomodation: the ability to rapidly re-focus the eyes when looking at something up close, then from a distance, and back again

What is vision therapy?

If the results of the assessment indicate that visual skills are too weak to support age appropriate activities, vision therapy may be recommended. Vision therapy typically includes a program of progressive “exercises” that address the child’s specific visual needs. They are usually performed in the doctor’s office once or twice a week. Frequent reevaluations are performed to closely monitor progress. Home exercises may be prescribed to facilitate more rapid progress.  

Why would my child’s occupational therapist refer me to a developmental optometrist?

Occupational therapists screen oculomotor control, assess and treat deficits in visual perception, or the ability to interpret and analyze visual information accurately, and visual motor integration, or eye-hand coordination. However, an occupational therapist may refer a child to a developmental optometrist if there is a cluster of symptoms that indicate that vision deficits are affecting a child’s functional performance at home or in school not attributable to postural control, fine motor, or visual-motor skills alone.

References: Scheiman, M. Understanding and Managing Vision Deficits: A Guide for Occupational Therapists. Thorofare, NJ: SLACK Incorporated, 1997.

 www.covd.org

 www.childrensvision.com

 Blog written by: Aviva Goldwasser, MS, OTR & Chaye Lamm Warburg, DPS, OTR, Director of POTS

This entry was posted on Wednesday, February 9th, 2011 and is filed under Parenting.

Preventing & Managing Meltdowns

Monday, January 17th, 2011

Children with a Sensory Processing Disorder (SPD) also termed Sensory Integration Dysfunction (SID) often need to learn appropriate “student behaviors.” Since many children with SID appear to the casual observer to be no different than other children, their unusual behavior is often surprising when it surfaces, and puzzling in its inconsistency. When observed over time, at varying times of day, and in a variety of settings, a picture of sensory integration dysfunction many begin to emerge more clearly.

It should be assumed that all children want to please the adults in their lives. For those children with SID, that can be a tall order to fill. All too often their sensory irregularities cause them to focus inwardly in order to satisfy their bodies’ needs at the expense of behaving in a socially acceptable manner pleasing to adults and engaging to other children. As parents and teachers our job is to provide all children with a physically and emotionally supportive environment that will value and accept them.  

  •  Children are not usually “bored”. Figure out why a child is inattentive or resistant to participate.  It could be physical discomfort or lack of skill
  • Be a detective. Look for and record antecedents to explosive behavior
  • Take note of the content and manifestation of the behavior (i.e. a child covering his ears; pushing the child next to him)
  • Look for socially acceptable replacements to sensory-based behaviors (i.e. chewing gum to replace disruptive noise making)
  • Have a “safe spot” in the classroom where the child can go on his own when he feels overwhelmed.  Model this critical coping mechanism
  • Give advance warning about transitions or changes in schedule
  • Acknowledge that you recognize and understand what makes him uncomfortable. Simply stating it can help diffuse the surrounding tension
  • Empower the child to help figure out a solution. For example, “I know you don’t like how crowded it is when the other class comes in for a story. Where would you like to sit so that you can enjoy the story too?”

If you feel that the child is on the verge of “losing it”, or has begun to meltdown already, try the following suggestions:

  •  Remove him from the stressful situation and use a quiet, calm voice to discuss what is happening
  • Have him give you a hug first, then ask if you can hug him back – a big total body hug
  • Give slow back rubs or massages
  • Give “grounding”  shoulder squishes by applying deep, even pressure downwards on the shoulders and along the arms pressing inwards
  • Do not try to rationalize with a child during a meltdown

 

Blog written by: Aviva Goldwasser, OTR

This entry was posted on Monday, January 17th, 2011 and is filed under Parenting.

Beyond Baby Einstein

Sunday, May 30th, 2010

The Role of Media in the Lives Young Children

The first in a 4 part series on Screen Time

Let me lay out my biases at the outset. I raised 5 children with no TV, but one video allowed on Saturday nights. Based on the research I will present to you, I wouldn’t change a thing!

Nothing but the Best

We all want to the best for our children, and secretly, many of us hope that our babies will turn into superstars. This is precisely why we are such easy prey for advertisers who claim either directly, by making specific claims about how a DVD will boost brain capacity, or indirectly, by labeling a DVD something like “Brainy Baby,” implying that a DVD will make your child a genius. As soon as we are alerted to a method for proactively boosting our child’s intelligence we feel irresponsible if we don’t rush to buy the toy or DVD, play the music, or join the class. Media in particular has undermined parents’ confidence in their own ability to foster child’s development. Let’s place this phenomenon is its proper historical context.

A Brief History of the Rise of TV

Television became readily available in 1950. At that time families maxed out at one TV per household and all content was family-friendly. By 1955 ¾ of U.S. household owned a TV set. Now a typical household has two to three TV sets, and there are more TV sets than toilets in developing countries

TV and screen time has taken over the lives of children. Fast forward to the 2000’s. American children spend more time with TV, computers and media than any other activity but sleep. Young children spend an average of 3-4 (up to 6) hours a day watching TV, which means that children under the age of two, who sleep 10-12 hours a day, spend 30-40% of their waking hours watching TV at home. That does not include non-parent supervised TV. Day care adds an additional 1.39 hours/day.

Is Screen Time Helpful, Harmful or Neutral?

The American Academy of Pediatrics has recommended no TV for children birth through the age of two. Older children should watch no more than 1 or 2 hours/day. This advice is largely ignored. Why? because of the seductive nature of baby videos and DVDs.

Next week we will track the rise of TV marketed to the under two crowd and discuss the impact of TV on the development of language, intellectual skills and attention. The news is not good.

Written by:

Dr. Chaye Lamm Warburg, DPS, OTR/L

Director

Assessment

This entry was posted on Sunday, May 30th, 2010 and is filed under Parenting.