Category Archives: autism

Spatial Awareness and Sound: “Hearing” The Space Around You

connor-wang-749757-unsplash

Just floating along in a big ocean……..

I hear a lot about kids who aren’t comfortable in big spaces: cafeterias, churches, gyms. Many parents, and even some therapists, attribute it to lack of familiarity: these are places they use inconsistently and are filled with more strangers.  Or they mention noise intolerance:  to music, to shouting, and to sounds like balls bouncing or people clapping.

But how about spatial issues?  We use our hearing to know where we are in a space, and to monitor our position in relation to people and objects as we move through space.  Kids who are poor at orientation to sound (I hear it, and I know where it is coming from) are usually also fair to poor at discriminating sound (I know what that sound is like and what it is or could be).  They may have a diagnosable hearing issue, or they may have a processing issue with no organ limitation.  Or they have both.

As sounds bounce off surfaces, we hear them and determine, like RADAR, how close we are to that surface.  We might turn our heads slightly, but we can hear in both ears, giving us stereo comparisons that tell us about what is behind us, above us and even below us.

In large spaces, sounds are “swallowed up” and give us less information.  This is part of the design of gothic cathedrals; you have a different sense inside them, a sense of being a bit “lost”, of how small you are in the face of the almighty. Not just luck.  Our ancestors understood the effect of altering spatial awareness on our sense of safety and stability.  But for people with spatial issues, they feel uncomfortably lost, very off kilter in environments that make them struggle to get a sense of their position in these types of locations.  For kids with poor sensory processing, it can happen in a grocery store or a new classroom.

What other sense is involved in spatial awareness?  Vision.  Vision is only helpful for about the 180 degrees in front of us, and not all of that vision is acute.  Our peripheral vision is fuzzy but still gives us some information about things going on to our extreme right and left.

The kids with poor auditory skills will use their vision excessively, and the kids with poor vision will try to use their auditory skills to shore up what they can’t see.  What does this look like?  Kids who are turning their heads constantly as they move, trying to get a sense of their location as they move, when their auditory system should be telling them about the distance between them and the boundaries of the room and it’s contents.  Kids who seem to hear everything, and yet not your voice telling them not to step on their brother’s LEGO car, which they don’t seem to see on the floor.

Poor spatial awareness often makes kids anxious.  This can sometimes be interpreted as a psychological issue, but CBT and drugs will never make it better.  That is a hint that perhaps it is a sensory issue.  Spatial issues can also make kids rigid about where they will go.  They may refuse unfamiliar parks, pools, playgrounds and new classrooms.

What can you do to help kids?  Work on auditory and visual skills, and always use vestibular and proprioceptive input as modulators and regulators.  I especially like the Therapeutic Listening Spatial series.   I am using the “Space” and “Body n’ Space”Quikshifts successfully Quickshifts: A Simple, Successful, and Easy to Use Treatment For Processing, Attention and Postural Activation with so much less hassle than the modulated music; they are downloadable too!

Spatial skills are important for kids to function in school, home and the community, and they can be improved!

shawnn-tan-265187

Teaching Safety Awareness To Special Needs Toddlers

daiga-ellaby-699111-unsplash

Parents anxiously wait for their special needs infants to sit up, crawl and walk.  That last skill can take extra months or years.  Everyone, and I mean everyone, uses walking as a benchmark for maturity and independence.

They shouldn’t.  A child with poor safety awareness isn’t safer when they acquire mobility skills.  Sometimes they are much less safe.  Yes, they may be able to move without your help, but they may need to be more highly monitored and given more assistance to learn how to be safe.  They are exploring their environment and their new skills that took them a long time to develop.  They have been wanting to climb on the couch for months.  Now they can.  Getting down the “safe” way isn’t as important to them, and maybe not as easy as sliding or rolling off.  Oops.

What can parents do to help their child be a safer (notice I didn’t say “safe”) ambulator, crawler, cruiser, etc?  

  1. Talk about safety before they are independent.  Will they understand what it means?  Probably not, but your tone and your insistence on how movement is done says that you value safety and you want them to do the same.  Kids learn from all of our actions.  Make this one familiar to them by being very obvious and explicit.
  2. Take your physical therapist seriously when she or he teaches you how to work on core strength and balance skills.  Yes, I still maintain that safety is more than a sensory-motor skill, but having the best possible sensory and motor skills is important.  Having good safety awareness and safety behaviors without these skills will make a child more vulnerable to falls and injuries.
  3. The same goes for sensory processing activities.  If your child cannot perceive the movement of falling, the tactile and proprioceptive change as they crawl or step on something, or tolerate multiple sensory inputs at once, they are much less safe, even with good strength and coordination.  Really.
  4. Know your child’s cognitive and social/emotional skills.  Impulsive children are less safe overall.  Children that cannot process your instructions or recall them without you are less safe.  Children that enjoy defying you more than they want to avoid falling are less safe.  If you know any of these things, you can gauge safety and react more appropriately.  You will be less frustrated and more helpful to them.
  5. Reward safe execution and do not reward unsafe behavior.   My favorite way to avoid punishment but also to send my safety message home?  Not providing eye contact or much at all in the way of conversation as I stop unsafe actions, and either removing a child from an unsafe situation or assisting them in using the safe method to execute their move.  They get no satisfaction from seeing me react strongly, and they get the message that I am not accepting anything but their best safety skills as they move.
  6. Stop a child that is moving in an unsafe way, and see if they can recall and initiate the safe choice before assisting.  You don’t want to teach them that only you will make them safe and they need someone to be safe out there. They have to learn how to assess, react and respond, and all children can build their skills.  Some need more teaching, and some need more motivation to begin to take responsibility for their safety.  Give them both.

david-clode-635942-unsplash

 

Toilet Training For Preschool And Stuck in Neutral? Here’s Why…..

irina-blok-192240-unsplash.jpg

Many of my clients are in a rush to get their kid trained in the next few weeks for school. They have been making some headway over the summer, but things can stall out half-way through.  Here are some common reasons (but probably not all of them) why kids hit a plateau:

  1. They lose that initial boost of excitement in achieving a “big kid” milestone.  Using the potty isn’t an accomplishment now, it is just a chore.
  2. Parents and caregivers aren’t able to keep up the emotional rewards they need.  It is hard to be as excited about the 10th poop in the potty as the first time.
  3. The rewards used aren’t rewarding anymore.  A sticker or a candy might not be enough to pull someone away from Paw Patrol.
  4. An episode of constipation or any other negative physical experience has them worried.  Even a little bit of difficulty can discourage a toddler.
  5. Too many accidents or not enough of a result when they are really trying can also discourage a child.
  6. Using the potty is now a power play.  Some kids need to feel in control, and foiling a parent’s goal of toileting gives them the feeling that they are the ones running the show.  “I won’t” feels so much better than “I did it” for these kids.
  7. Their clothes are a barrier.  When some families start training, it is in the buff or with just underwear.  Easy to make it to the potty in time.  With clothes on, especially with button-top pants or long shirts, it can be a race to get undressed before things “happen”.
  8. They haven’t been taught the whole process.  “Making” is so much more than eliminating.  Check out How To Teach Your Child To Wipe “Back There” and The Ten Most Common Mistakes Parents Make During Toilet Training for some ideas on how to teach the whole enchilada.  And if you need a great book for kids without developmental or motor delays, look at my review A Great Toilet Training Book for Neurotypical Kids: Oh Crap Potty Training!.

Should you pause training? The answer is not always to take a break.  I know it sounds appealing to both adults and kids, but saying that this isn’t important any longer has a serious downside.  If your child has had some success, you can keep going but change some of your approaches so that they don’t get discouraged or disinterested.  If your child really wasn’t physically or cognitively ready, those are good reasons to regroup.  But most typically-developing kids over 2 are neurologically OK for training.  They may need to develop some other skills to deal with the bumps in the road that come along for just about every child.

Sometimes addressing each one of these issues will move training to the next level quickly!  Take a look at this list and see if you can pick out a few that look like the biggest barriers, and hack away at them today!

For kids with low muscle tone, including kids with ASD and SPD, take a look at my e-book, The Practical Guide to Toilet Training Your Child With Low Muscle Tone.  Read Why Low Muscle Tone Creates More Toilet Training Struggles for Toddlers (and Parents!) to understand why I wrote this book just for you!   

I give parents clear readiness guidelines and tips on everything from the best equipment, the best way to handle fading rewards, to using the potty outside of your home.  It also includes an entire chapter on overcoming these bumps in the road! To learn more about what my e-book can do for you, read The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived!

Calm Your Toddler By Using “Tummy Time” for Emotional Modulation

 

hal-gatewood-336679

You don’t have to offer your child a tablet.  Try a book or a sticker activity instead!

Yes, tummy time.  It isn’t just for babies anymore.

Why?  Because occupational therapists know that the physical effects of working against gravity to push one’s head and shoulders up, and the firmness and warmth of contact with the floor are also sensory-based modulation strategies.  What helps babies build core control can also calm upset or disorganized toddlers and older kids.

The decrease in visual input can improve calmness and attention for those kids whose eyes dart everywhere.  Not everyone can handle a visual stimulating room.  Some children need more vestibular input to reorganize, but some do better with the stillness of “tummy time”.

How long do they need to be on their stomachs for this to work?  It depends.  Probably more than a few minutes, but if you haven’t seen signs of better modulation (better eye contact, slower breathing, more communication, less agitation) then you might need to layer on another technique  Help Your Child Develop Self-Regulation With Happiest Toddler On The Block or the Wilbarger Protocol Can You Use The Wilbarger Protocol With Kids That Have Ehlers-Danlos Syndrome?.

Having trouble convincing your child to lie on their belly?  Join them, or get a sibling to model it.  Make a special new book collection for tummy time, and only have it available at that time.  Get a tent, and add the effects of an enclosed space to tummy time to make it more deeply calming.

lex-sirikiat-372115

 

KickStart Kindergarten: Get Your Child Ready for Kindergarten Writing The Easy Way!

 

img_1397.jpg

Starting kindergarten is so exciting for most kids, but learning to write can be challenging for those children that have fASD, SPD, fine motor or visual-motor issues.  Even though fewer and fewer teachers know how to teach handwriting well, it is still a necessary skill for young children.  Learning Without Tears has developed an amazing book that can help your child build skills faster and easier:  Kickstart Kindergarten!

Why Writing (Still) Really Matters

There are research studies that suggest that the physical act of forming letters positively affects memory and comprehension.  These studies suggest the benefits continue all the way through into college-level instruction.  Handwriting is a multi-sensory experience.  The brain is using many different areas of the brain are involved in organizing and coordinating it’s tasks to execute the ability to write.  Young brains need to practice and achieve a high level of coordinated activity before they can focus on comprehension and critical thinking.

The demands of writing create neural activity that could be considered  “brain exercise”.   I know I see it that way.  Taking notes at the high school and college level requires synthesis; the cognitive act of summarizing and condensing a lecture into a shorter message that you write down quickly.  It is a mental skill not required when you take verbatim notes on a laptop.  Oops.

Simply put, the reason keyboarding and digital access isn’t enough is simple:  by the time struggling writers are able to put their thoughts into words in a digital format, they have already developed frustration and even aversion to engaging in writing in any form.  

This is unacceptable to me.  Clever and creative kids are learning to dislike language arts because they can’t write with enough skill and speed.  I have struggling writers ask me: “How many words do I need in each sentence, and how many sentences”  This isn’t making them develop their ability to compose anything.  It is making them hate language arts.  At a time where communication skills are essential to success at any profession.

Kickstart Kindergarten:  Fun, Well-Designed, and Easy to Teach:

This workbook is the one you want to give your new preschool graduate this summer!  Kindergarten has become more academic.  That isn’t an endorsement.  It is a fact, and the kindest thing to do for children is to give them the best materials to achieve the skills they need to succeed.  This book is designed to boost the automaticity needed to go to kindergarten.  What is that?  To perform language arts curriculum, your child needs to be able to write with ease.  If they have to think about how a letter is made, that takes away the brainpower needed to think about spelling and expression.  Whole language has been proven to be a whole failure.  There are teachers who haven’t read the research and administrators stuck in 1985 when they finished grad school.  You can’t help them, but you can help your child!

Here are some, but not all, of the terrific features of this workbook:

  • As with all HWT books, the paper is sturdy and won’t tear with repeated erasing or careless handling.
  • The individual letter pages start with tracing and fade to independence.
  • The gray boxes help kids with consistent and age-appropriate sizing and avoid reversals.  BTW, reversals are normal at this age.  Preventing reversals is even better than correcting them.  This book does both.
  • Each sample is placed near the space available for a child to write.  They don’t need to move their hand or copy the errors they made in the previous attempt (big issue for any kid with ocular control issues or visual organization issues!)
  • Letters are grouped into developmentally-correct bunches, based on the later pre-K motor developmental milestones.  This means that an “A” isn’t the first letter learned.  Letters that are all vertical and horizontal lines are the easiest to form, so they are first.
  • There are still coloring opportunities and plenty of chances to repeat and practice.
  • They include pages for parents and teachers to use as formation references.  You can’t teach writing if you aren’t sure how a letter is supposed to be formed.  I will confess that after taking the evaluation course, I found out that I have some very bad habits that probably date back to preschool.  And never got fixed.
  • Numbers are not ignored.  Numbers are presented in order, but their formation is actually not far from a developmental progression.

Here are some screen shots to get you excited about this book:

IMG_1398IMG_1399IMG_1401

Is your child entering first grade, but clearly in need of more practice?

These books aren’t going to make them feel self-conscious about needing help.  Take off the cover if you are worried that they will be embarrassed to use a book with “Kindergarten” in the title.  And tell them that this is the easiest way to get better at handwriting …fast!  You have their back, as always!

Why Pediatric Occupational Therapists Need The Happiest Toddler On The Block Techniques: Neurobiological Regulation

joshua-coleman-655076-unsplash

 

Pediatric occupational therapists are usually all-in when it comes to using physical methods to help children achieve affective modulation.  We use the Wilbarger Protocol, Astronaut Training, Therapeutic Listening, and more.  But are we using Dr. Harvey Karp’s Happiest Toddler on the Block techniques?  Not so much.  All that talking seems like something a teacher or psychologist should do.  Folks, it’s time to climb off that platform swing and look at all of the ways children develop state regulation.  Early development is the time when children experience attunement with caregivers and create secure attachment.  But this is a learning process that grows over time and can be damaged by events and by brain-based issues such as ASD.  The Happiest Toddler on the Block techniques aren’t billed as such, but they are the best methods to create attunement and attachment while teaching self-regulation skills that I have found.  Combined with sensory-based treatment, progress can be amazing!

Research has told us that the way we interact with children and the way they feel has direct effects on neurotransmitters and the development of autonomic reactivity.  If you don’t believe me, check out Stephen Porges’ work on the ventral vagal component of the autonomic nervous system.

When we use The Fast Food Rule, Toddler-Ese and Patience Stretching ( Use The Fast Food Rule to Help ASD Toddlers Handle Change and Stretch Your Toddler’s Patience, Starting Today! ) to get a child focused, calm, listening, and recognizing that we “get them” even if we don’t agree with their toddler demands, we shift more than behavior.  We shift their neurophysiological responses that can become learned pathways of responding to stressors of all kinds.  We are using our social interactions to create neurobiological regulation.  I believe that the use of Happiest Toddler techniques can make a significant neurophysical change in a young child even before we put them on a swing.  I am going to go out (further) on a limb and say that if our interactions aren’t informed by understanding attunement and engagement, our sensory-based treatment might be seriously impaired.

Long story short:  if you aren’t using effective methods of developing social-emotional attunement and engagement with young children, your treatment isn’t taking advantage of what we now know about how all children learn self-regulation.  And if the child you treat has ASD, SPD, trauma from medical treatment, etc…..you know how important it is to use every method available to build the brain’s ability to respond and self-regulate.

conner-baker-480775

 

For Kids With Sensory Issues and Low Tone, Add Resistance Instead of Hand-Over-Hand Assistance

 

leo-rivas-micoud-30808

One of my most popular posts, Why “Hand-Over-Hand” Assistance Works Poorly With So Many Special Needs Children , explains how this common method of assisting children to hold and manipulate objects often results in rejection or even aversion.  This post tells you about my most successful strategy for kids with low muscle tone and limited sensory processing:  using graded resistance.

Why does making it harder to move work better?  Because if the child is actively trying to reach and grasp an object, you are providing more tactile, kinesthetic and proprioceptive information for their brain.  More information = better quality movement.  Your accurately graded resistance is doing what weighted/pressure vests, foot weights and SPIO suits do for the rest of their body.  Could you use a hand weight or weighted object?  Maybe, but little children have little hands with limited space to place a weight, and weights don’t distribute force evenly.  Did you take physics in school?  Then you know that gravity exerts a constant pressure in one direction.  Hands move in 3-D.  Oh, well.  So much for weighting things.

How do you know how much force to use?  Just enough to allow the child to move smoothly.  Its a dance in which you constantly monitor their effort and grade yours to allow movement to continue.

Where do you place the force?  That one is a little trickier.  It helps to have some knowledge of biomechanics, but I can tell you that it isn’t always on their hand.  Not because they won’t like it, but because it may not deliver the correct force. Often your force can be more proximal, meaning closer to the shoulder than the hand.  That would provide more information for the joints and muscles that stabilize the arm, steadying it so the hand can be guided accurately.   If a child has such a weak grasp that they cannot maintain a hold while pushing or pulling, you may be better off moving the object, not the hand,  while they hold the object, rather than holding their hand.

Still getting aversive responses from the child?  It may be because the child doesn’t want to engage in your activity, or they don’t realize that you are helping them.  They  may think that adults touch them to remove objects from their grasp or otherwise stop them from exploring.  Both can be true.  In that case, make sure that you are offering the child something that they want to do first.  Remember, we can’t force anyone to play.  The desire to engage has to come from them, or it isn’t play.  Its just adults making a kid do something that we think is good for them.

Want more information on how to help children build hand skills?  Read Using A Vertical Easel in Preschool? WHERE You Draw on it Matters! and Egg Crayons or Fingertip Crayons: When Good Marketing Slows Down Fine Motor Skill Development.

dan-preindl-539496

One of the most amazing places I have ever seen:  Australia!

OXO for Kids: Great Tableware For Older Kids With Sensory and Motor Issues

shopping-2.jpeg

shopping-1.jpegshopping.jpeg

Does your child knock over her milk on a daily basis?  Do utensils seem to fly out of your son’s hands?  I treat kids with hypermobility, coordination and praxis issues, sensory discrimination limitations, etc.; they can all benefit from this terrific line of cups, dinnerware and utensils.

Yes, OXO, the same people that sell you measuring cups and mixing bowls: they have a line of children’s products.  Their baby and toddler items are great, but no 9 year-old wants to eat out of a “baby plate”.

OXO’s items for older kids don’t look or feel infantile.   The simple lines hide the great features that make them so useful to children with challenges:

  1. The plates and bowls have non-slip bases.  Those little nudges that have other dinnerware flipping over aren’t going to tip these items over so easily.
  2. The cups have a colorful grippy band that helps little hands hold on, and the strong visual cue helps kids place their hands in the right spot for maximal control.
  3. The utensils have a larger handle to provide more tactile, proprioceptive and kinesthetic input while eating.  Don’t know what that is?  Don’t worry!  It means that your child gets more multi-sensory information about what is in her hand so that it stays in her hand.
  4. The dinnerware and the cups can handle being dropped, but they have a bit more weight (thus more sensory feedback) than a paper plate/cup or thin plastic novelty items.
  5. There is nothing about this line that screams “adaptive equipment”.  Older kids are often very sensitive to being labeled as different, but they may need the benefits of good universal design.  Here it is!
  6. All of them are dishwasher-safe.  If you have a child with special needs, you really don’t want to be hand-washing dinnerware if you don’t have to.

For more information about mealtime strategies, please take a look at Which Spoon Is Best To Teach Grown-Up Grasp? and Teach Spoon Grip By Making It Fun And Sharing a Laugh With Your Child.

thanh-tran-369711.jpg

What Helps Sensitive Kids Handle Haircuts?

kevin-gent-437469

Depending on your child’s age and issues, getting a haircut can be anything from a chore to a dreaded event that you put off, and then put it off a bit more.  So many kids fear them:  kids with ASD, kids with sensory issues, children that have had multiple hospitalizations or procedures, children with anxiety disorders.   I have been asked by parents of children well into grade school to help them with the problem of getting their child to the barber or hairdresser without a major fight.  My strategies are informed by my training as a pediatric OTR and as a Happiest Baby on the Block educator.

My approach to improving a child’s tolerance for a haircut is based on three goals: reduce the novelty of the experience, reduce the sensory impact of the haircut, and build their overall coping strategies based on their developmental level.

  1. You can borrow techniques from “exposure therapy” to make the experience of getting a haircut more familiar.  The very first step could be making combing or brushing their hair a non-event.  Explore what tool is the most comfortable for your child, and gradually introduce combs and even hair clippers.  Let them turn the clippers on and off ( establish safety rules first) and let them hear the clippers both far away and close to their ears.  Let them comb their hair first, then allow you to do so.  Washing their hair in the bath is another experience that you can use for pretending that you are giving them a haircut.  You can also get a bit wet and allow  them to pretend to cut your hair.  I have safety scissors that don’t cut anything but paper  Lakeshore Scissors for Toddlers That Only Cut the Paper, Not the Toddler  that work very well for this experience.  Expand grooming so that it can happen at different times of the day and in different locations in your home.  It needs to become as much of a non-issue as possible at home before a child is truly comfortable in the hair salon.
  2.  Remember that the entire experience of receiving a haircut has strong sensory components:  the salon and the sight, sound and smell of it’s other staff and customers, the tools used to cut hair, the feel of the chair and the drapes on your child.  They can all be contributors to agitation and aversion.  How can these be minimized?  Early appointments might be less crowded, there may be ways to apply water or lotions to reduce the experience of being sprayed, or children can be actively involved in saying that they are ready rather than feel attacked when they don’t expect touch.  Some kids just to be told before the event that their hair will be sprayed, or they need to feel in control of the timing.  Your child may seem too old to sit on your lap, but it could help them stay calm.  Ask if this is something they would like.  Your hairdresser is interested in doing a good job without a lot of drama.  Most of them will work with you.
  3. Many of the kids I see that struggle with haircuts also struggle handling frustration and anticipatory anxiety in general.  They are used to big dramatic exchanges when asked to do the things that are expected of them that they CAN tolerate.  These kids have often spent years developing a dance of refusal and opposition that they are now stuck in with their parents.  In my sessions, they quickly learn that I don’t engage this way; I am a no-drama girl.  I set limits and consequences, and I provide options so they feel they are working with me, not against me.  I use Dr. Harvey Karp’s Fast Food Rule and use all of his “Feed The Meter” strategies Turn Around Toddler Defiance Using “Feed the Meter” Strategies to build a sense of compassion and communication.  Both of these Happiest Toddler strategies work well with older children because anyone that is upset is thinking and behaving at a lower developmental level.  My best strategy is simple:  I stop a challenging task before a child has the chance to bail.  I may introduce another task that is similar and still offers challenge.  Stopping isn’t always ending the overall challenge.   The child’s experience is that they don’t have to fight to get a break, as for support or have adjustments made.  I am now their partner in learning to handle haircuts, dressing or nail cutting, not an authority making demands.
  4. Try not to minimize their distress, even if you can’t see why they feel that way.  In Why Telling Your Toddler “It’s OK” Doesn’t Work (And What To Do Instead)  , I wrote about how important it is to actively validate a child’s perspective.  with children that have sensory issues, this is huge, absolutely huge.

It is my belief that if you can help a child handle the daily challenges of their life with compassion, respect and skill development, that child will trust that you can help them with the other events in life that make them frightened or overwhelmed.  They have a new sense of how to manage their behavior, and believe that adults are resources for learning and partners in growth.

Looking for ideas on nail trimming or dressing as well? Read Why Cutting Nails Is Such a Challenge for Autistic and Sensory Kids and Dressing Without Tears: Sensory-Sensitive Strategies That Work

And don’t forget that my e-book on toilet training is out there to help you with this challenging skill:  The Practical Guide To Toilet Training Your Child With Low Muscle Tone isn’t just for kids with low tone; kids with ASD and sensory processing issues can use these strategies to build skills that help them make real progress quickly! You can buy my e-book on my website Tranquil Babies, at Your Therapy Source (a terrific site for OT workbooks and other products), and on Amazon.

himanshu-singh-gurjar-106819

How Parents Can Teach Healthy Body Boundaries To Young Children

 

ahmed-saffu-307321

One of the greatest horrors of the Larry Nasser story is that parents were often mere feet away from these girls while they were being molested.  The people most invested in a child’s safety had no idea that anything violent was occurring, and these girls did not reveal their discomfort at the time.  These parents are beyond distraught now, and often filled with guilt.  I do not blame them for what happened.  They were deceived by Nasser and their children weren’t able to communicate their distress or confusion.

Parents who read these news reports are wondering how they would react; would they recognize abuse?  And they are wondering what to say and do to prevent this from ever happening to their own children.

My strong belief is that there will always be people like Larry Nasser in the world, and that children who have experience with being touched with respect could be more likely to recognize and report abusive touch, even when it comes from an authority or a family member.

I would like to share my best suggestions to teach children the difference between healthy touch and invasive touch, drawn from my practice as a pediatric occupational therapist who treats children with ASD and sensory processing disorders.  I would also like to say very clearly that there is never any reason for any occupational therapist to make contact with a child’s genital area.  Ever.  But since parents and caregivers perform diaper changes, dress children, and provide bathroom assistance, it is important to me to teach the following strategies for respectful contact in therapy so that children have a sense of what type of touch is unacceptable:

With non-verbal children of any age, I use a combination of observation, use of my own body language before I begin physical contact in therapy.  If children can make eye contact, I use visual regard to establish a connection, and I do not initiate physical contact quickly.  If they cannot meet my gaze, I read their cues, and often wait for them to come closer to me and reach out.  I use intermittent touch that avoids hands, face and feet initially.   Deep pressure is less alerting to the nervous system than light touch, so my contact is stable, slow and steady.  I will describe what I am doing therapeutically, in simple statements with calm tones, even if I am not sure that they will understand me.   I remove my contact when I see any indication of agitation, and before a child protests strongly.  What I am communicating is “I get you.  I see you and I respect you.  I will not force you, but I will invite you to engage with me”.

With children that can communicate verbally, I do all of the above strategies, and I ask permission.  Not always in complete sentences, and not always using the word “touch”.  I constantly tell them what I am going to do or what movement I am going to help them to accomplish.  It doesn’t matter if they fully comprehend my words; they can read the tone in my voice.  If they protest, I will voice their protest without criticism “You want no more _______; no more __________.  OK.”  I reconsider my approach, adjust, and either begin contact again or shift activities to build more tolerance and trust.

With slightly older children that can understand my question and can respond clearly, I will teach them that they have a choice about greetings.  I teach “Handshake, Hug or High-Five?“.  Children get to choose what kind of physical contact they wish to have when greeting me or other adults.  I must agree to their choice.  I encourage parents to teach their family members to offer this choice and to never force a child to kiss/hug or accept a kiss or a hug from anyone.  Children need to feel that they have agency over their bodies without criticism.

Anyone who remembers enduring a sloppy smooch or a crushing hug from a relative can relate.  You may or may not have actively protested.  It doesn’t matter.  Allowing an adult to have this form of contact with a child is not just an irritating experience for them.  It is a serious message that children of all genders are given:  The people that are in power have the right to do things to your body that you don’t like, and you have no right to complain.

Is this the message that parents intend?  Of course not, but that doesn’t make it any less a clear communication.  Larry Nasser and his kind depend on a combination of authority, status and compliance to perpetrate abuse, even if the child’s parents are in the room.  I believe that children who know that any uncomfortable touch from any adult, even those closest to them, can be refused, they are more likely to recognize and report abuse. They will be believed and they will not be shamed.

dawid-sobolewski-318745

 

Stop The Whining With The Fast Food Rule

conner-baker-480775

Whining is a “fingernails on a chalkboard” experience for most adults.  We often give in to a whining child, just to avoid hearing that noise.  Or we explode and scare them (and ourselves) with the anger that whining can trigger.  What can you do?

What would you say if I told you that I use a technique that works more than 50% of the time, and it can work in mere seconds to halt a child in mid-whine? Well, read on and let me tell you the secrets that I learned from Dr. Harvey Karp and his Happiest Toddler on the Block book!

I spend more than 75% of my treatment day as an occupational therapist with children under the age of 6.  That can add up to a lot of whining!  Why?  Not because I am inexperienced, or because I am a pushover.  Anyone that knows me knows that neither statement is true.  It’s because young children may be able to talk, but they aren’t very good communicators.  Being able to express their feelings effectively and negotiate their desires is just beyond their pay grade at this age.  Their default is whining.

Dr. Karp’s Fast Food Rule has made my job so much easier. It makes young children see me as a friend, not just another adult telling them what to do.  This one simple strategy lets kids know that I care about how they feel, but doesn’t suggest that they will get their way with me every time.  In fact, they often find themselves following my directions without fully knowing why they have stopped crying, begging, or pleading with me.

Here is what the FFR entails:

Part 1:  Repeating what you believe is your child’s complaint or desire, using simple words, short phrases and more emotional tone and gestures/facial expression than usual.  You may not know for sure what a very young child wants, but take your best guess.  If you are wrong, you can always give it another try.  The more upset or younger the child, the simpler the wording and the more expressive the tone and gestures.  Why?  Because emotional people don’t hear you well, but they will pick up on your non-verbal cues effectively.  You are trying to convey a simple message:  I understand you.

Part 2:  Only after you see that your child has calmed a bit with the knowledge that they are understood can you then begin to comfort, negotiate, or solve their problem.  Not before. We jump in very early in the interaction to tell them “It’s OK, honey” or “I can’t hear you when you speak to me like that”.  It’s only when they know you have heard THEM that they can listen to YOU.

The importance of being understood by another when you are upset cannot be overstated.  Children need this from us more than we know.  Even young toddlers are aware that they won’t always get what they want, but they need to know that we understand their point of view.  If you do not convey this message, a child will whine, wail or scream to make it clearer to you that they are upset.  That is why telling them that things are fine seems to throw oil on the fire.  They think you don’t get it.

So, help them pull it together by stating their situation (as you perceive it) out loud and using some non-verbal messaging:  I got it.  You want more cookies.  You don’t want to leave the park.  You want Logan’s truck.  Whatever it is, tell them that you understand before you offer a solution, an alternative, or explain why they aren’t getting what they want.  I promise you, it will work more often than it does not, and sometimes it will work so well that you almost cannot believe how simple it was to calm things down.

There is a secret benefit from using the FFR:  your child will gradually become less likely to break out in a whine even when things have gone badly.  After repeated experiences of being understood and treated with respect and firmness, a child will expect that you are the source of solutions instead of a dumping ground for agitation and anger.

 

janko-ferlic-153521

 

Why Eating From a Pouch Isn’t Helping Your Child As Much As You Think

 

fay-422908

 

Sucking food from a pouch has become a common way to funnel fruits, veggies and even protein into young children.  Few kids are eating them because they have oral motor or sensory processing problems that don’t allow them to eat solid food.  Most of the pouch kids are picky eaters or eating a pouch “on the fly” in between activities and locations.

I know very well what a food fight looks like with a picky eater.  All that whining, food flying onto the floor, and fears that your child will either starve or be nutritionally deprived.  It can get ugly.  I know.  But when pouches are more than an occasional emergency ration, they aren’t without some costs.

Here is what you risk when pouches replace solid food:

  1. Your child’s digestive system needs the physical fiber to learn how to handle it well. A colon that has very little fiber isn’t capable of dealing with regular food as well.  You risk constipation and then you have to treat that problem.  And your child feels awful when “backed up”.  Don’t let them suffer that belly pain when they are capable of eating foods with fiber.  Natural fiber.
  2. If your child is young enough to be still learning to speak (and some sounds, like “th” don’t fully emerge until 3.5-5 years old), eating, chewing and even swallowing still counts as exercise and motor learning for all the structures/movements that accomplish this amazing task.  Sucking on a nozzle doesn’t support learning anything unless you are under 6 months old.  Oops.
  3. Eating is a social activity, done over time and with other humans.  Not with tablets, not with screens.  With people that model language, social and feeding skills.  Sucking down a pouch is a one-and-done experience that sends a child off their chair and back to playing too fast to absorb much of anything.
  4. Eating is a fine motor activity, from finger feeding to spoon use with soup.  Miss out on all that work, and you might find that your child is the slowest writer or even hates to write and draw.  They haven’t spent the first 3 years of life refining finger movements in the most rewarding way possible.  Food in: successful hand use.  Food on the bib/table/floor?  Recalculate and refine finger use.

What do those pouches really provide?  An easy way to feed a child nutritious food ingredients without an argument.  The problem is that all that work for kids and parents when they eat real food with their fingers or utensils is actually an investment in current and future skills that too many children need today.

Looking for more information on building self-feeding skills?  Read Teaching Children To Use Utensils to Eat: Use Good Tools, Good Food, and Good Timing for some hints on how to make things easier, and Teach Spoon Grip By Making It Fun And Sharing a Laugh With Your Child for the most fun and easy way to practice holding a spoon.

Help Your Special Needs Toddler Make The Transition To School Routines

 

wu-yi-302799.jpg

 

Many developmentally delayed toddlers move their therapeutic and educational services to a toddler developmental group, A.K.A. special needs program, when they are between 18 and 30 months old.  Not all of them slide into the routine easily.  There can be a few tears and a lot of complaining about fitting into a schedule /leaving a fun activity because it is time for circle or therapy.

After speaking with a handful of clients and doing a few consultations, I thought it might help to provide some strategies to help parents make their child’s first school experience easier:

  1. Learn how teachers mark activity transitions, and commit to using them at home.  Some teachers sing the  “clean-up song”, some ring a bell or turn lights on and off.  Find out exactly how the staff help children, especially non-verbal children, anticipate and adjust to changes.
  2.  You don’t need to copy the exact transition strategy, but make it very similar and use it for activities at home that are the easy transitions.  Examples of easy transitions at home are getting into a bubbly tub, leaving the table once full and satisfied, putting on a coat to go outside and play, etc.  The transitions that are easiest are going to be the calmest, and children learn best when calm.  This positive spin makes the school’s routine more acceptable when a child isn’t completely on board with new situations.
  3. Find out how snack is served, and offer snacks in the same way at home.  If small cups are used for water or juice, practice cup drinking at home with the same sized cup.   If there are specific foods offered, then stock up.   Model your enjoyment of these snacks so that the food is familiar and has your seal of approval.

Good luck this year to all the toddlers that have made the leap to school!!

 

Have More Halloween Fun When Kids Don’t or Can’t Trick-Or-Treat

rawpixel-804789-unsplash

 

Kids big and little are anticipating Halloween, but this holiday isn’t always enjoyable for children with ASD, SPD, anxiety or motor issues.  Putting on a costume can be difficult for some kids to tolerate and nearly impossible for kids that have mobility issues.  Kids with endurance and mobility issues struggle to walk up to a front door and ring the bell, but they don’t want to be carried “like a baby”.  Even seeing other children in costume or decorations in their own home can be difficult for children that are very sensitive.

What begins as a celebration and an adventure becomes a minefield.  And yet, your child may be invited to participate in many Halloween events.  You may want to have a party in your own home.  Your child may even beg to be involved in things you know they will end up hating, not realizing the challenges ahead.  Inclusion is a murky pond for some kids.

Perhaps it doesn’t have to be so difficult.  Here are a few ideas that could make this holiday less stressful and more inclusive:

  • Costumes can be anything you want them to be.  Purchased costumes can be adapted or altered for comfort and tolerance.  If you have a child with tactile sensitivity, choosing the fabric that is less irritating is worth a trip to a brick-and-mortar store, or ordering multiple sets online with easy returns.  Instead of an eye patch for a pirate, you can use makeup to create one.  Princess skirts and Batman pants can be shortened to prevent tripping.  They can be bought larger and altered to allow for braces and for sitting in a wheelchair.  Hats and headpieces are optional, and can also be switched out for more wearable choices.  They can be purchased separately or by combining two costumes.  A comfortable costume is fun; an awkward costume will cost you in time, pain and struggle much more than you can imagine.
  • Trick-or-treat is over-rated.  Choose people your child knows, a neighborhood that has flat, accessible front steps, or even an apartment building with an elevator.  The experience of trick-or-treat doesn’t have to be a marathon to be fun: in fact, “fun” is the opposite of dragging stressed children around from house to house.  Remember that children with sensory modulation issues will start out excited and happy and become overwhelmed quickly.  Monitoring and planning for this helps both of you have fun that doesn’t end badly.
  • Many children with sensitivities need to practice wearing their costume until it becomes familiar.  They may protest and initially refuse, but some practice can really help them.  Make the run-through more fun by pairing it with something like watching a halloween movie at home or putting up decorations.  The child that refuses to wear a costume can become the child who doesn’t want to take it off!
  • Choose your home decorations with your child’s tolerance in mind.  It isn’t always about whether they are scary or not, it can be the brightness, the amount of movement or the sounds that overwhelm children.  You won’t always know what will be too much, so prepare yourself and the rest of the family that you may have to substitute/remove/repurpose things that don’t work out.
  • Do fun events that your child can handle.  Bake cookies, including the buy-and-bake-off cookies that don’t require a lot of effort or time.  The end product can be given to friends and family proudly.  Decorate a Halloween cookie house.  Put up cling-on decorations in windows and storm doors that are easy to remove if they become an issue.  Watch a fun movie at home and invite friends to dress up and come over for the show.

Holidays for kids with special needs take more thought, but they don’t have to be less fun, just a bit different.  The important concept is to consider your child’s needs and aim for the essential feelings of the holiday:  fun, and sharing the fun with others!

rawpixel-1054665-unsplash

Lining Up Toys Doesn’t Mean Your Toddler Has Autism

 

danielle-macinnes-88493-unsplash.jpg

After head-banging (see Why Head Banging Doesn’t Make Your Toddler Autistic), this is the other common behavior that seems to terrify parents of young children.  Seeing a row of vehicles on the carpet makes parents absolutely sprint to search online.

Well, I want all of you to take a deep breath and then exhale.  The truth is that there are a few other behaviors that are more indicative of autism than head banging.

Here is what I think that row of tiny toys often means:

Very young children have a natural interest in order and understanding spatial relationships.  Kids like routine and familiarity way more than most adults.  Some children who line up toys are just experimenting with how lines are formed or seeing how long a row of cars they can create.  Some will even match colors or sizes.

It is OK if Lightening McQueen has to be the first in the line at all times.  Sometimes rigid routines have a beneficial developmental purpose.  When your child tells you that you just read Goodnight Moon wrong (you just paraphrased the story get him to bed), he is really saying that he likes the familiarity and the orderliness of hearing those words said in exactly that order.  Boring to you, comforting to him.

Experts in early literacy will tell you that a child’s fondness for hearing the same story over and over is actually a developmental milestone in phonemic awareness, the cornerstone of language mastery.

Controlling their environment and creating patterns is another reason to line up those cars.  Very young children (under an 18-month cognitive level) do not create complex play schemes about races or adventures.  Lining them up is developmentally correct play for these children, and it can easily expand with a little demonstration and engagement with you.  Build a garage from Megablox or MagnaTiles, and see if your child will enjoy driving each one into the garage to go to “sleep at night”.  Don’t mention that in real life we all use our garages as storage units, not vehicle parking!  Typically-developing children may even repeat this game independently later the same day, having learned a new way to play with their toys.  Or they will hand you a car and say “night-night?” so that you can play this game with them again!

When does lining up toys become troublesome?

When it is the ONLY way that your child interacts with those toys, or with any toys. And when you try to expand their play as above, they just about lose their lunch because it is all about rigid routines, not object exploration.  If your child is on the spectrum, that line of cars is part of their environmental adaptation plan for security and stability; it’s not actually play at all.  There isn’t a sense of playfulness about changing things around or using these objects for imaginative play.

A lack of developmentally-appropriate play skills is certainly a concern to a child development specialist, but it still doesn’t translate into autism.  Here are a few of the behaviors in 1-2 year-olds that concern me much more:

  • little or no eye contact when requesting something from you.  They look at the object or the container, not at you.
  • no response when her name is called, or not looking toward a specific person when the name of a family member is mentioned.
  • using an adult’s hand as a “tool” to obtain objects rather than gesturing, pointing or making eye contact to engage an adult for assistance.
  • a non-verbal toddler (over 18 months old) that doesn’t use gestures such as pointing or babbling to communicate needs or desires.

Always discuss your concerns with your pediatrician, and in the U.S., consider a free evaluation through your local Early Intervention program if you continue to see behaviors that keep you up at night.  Therapy services are free as well, and they continue until your child is eligible for school-related services provided by your local district.

3/21/20:  Since parents are particularly concerned about coronavirus, please read How to Get Young Children to Wash Their Hands to make this as easy as possible. Then read Is Your Toddler Home From School? Save Your Sanity With Fun Routines !!

Most posts to help you!

Need more help with your child’s behavior?

I have transformed my own reactions to challenging toddler behavior with Dr. Harvey Karp’s Happiest Toddler on the Block methods.  To teach your child self-control skills without punishment or shaming your child, take a look at Stretch Your Toddler’s Patience, Starting Today! and Discipline and Toddlers: What Do You Say if You Don’t Want to Constantly Say “No”? .  If your child is on the spectrum, these strategies will work for you as well.  It may take longer for success, and you may have to look for small signs of comprehension and calmness, but they will work.

Are you struggling with potty training your child with low tone?  Then I wrote a book just for you!

 The Practical Guide to Toilet Training Your Child With Low Muscle Tone is the e-book that gives you real assistance, not just “don’t rush him” or “wait until you see signs of readiness”.  What a cop-out from pediatricians!!  I teach you how to spot and create readiness, and build your child’s skills so that they can succeed! Read more about my book at The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived! .  You can purchase my e-book on my website Tranquil Babies , on Amazon , or at Your Therapy Source , a terrific site for occupational therapy materials.

My newest e-book is finally done!  

The JointSmart Child:  Living and Thriving With Hypermobility Volume One:  The Early Years helps parents of kids with low muscle tone and joint instability figure out things like how to position their child in a stroller properly, how to teach them to eat with a spoon, and how to pick the best chairs, trikes, toys and even pajamas!

Parents who know what to do and what to expect feel empowered, not anxious.  There are even chapters on how to communicate with teachers, doctors, and even members of your family so that you get the right kind of support and your child is both safer and more independent….today!

It is available as a read-only download on Amazon and as a printable and click-able download (and they are also offering an option to bundle it with my first e-book, saving you some money!) at Your Therapy Source

cindy-bonfini-hotlosz-354736-unsplash.jpg

The Difference Between Special Needs and Typical Potty Training Approaches: Address Sensory/Behavioral Issues and Use Consistent Routines

tai-jyun-chang-270109.jpgAfter writing The Practical Guide to Toilet Training Your Child With Low Muscle Tone, I have been asked what was different about my book. There must be 100 books on potty training special needs kids. What did I do differently? Simple. I am an occupational therapist, so I have no choice but to use my 360 degree viewpoint to target all the skills needed to do the job. Seeing the path to independence in this way was second nature to me, but not to parents of kids with special needs. Time to offer some support!

The books I reviewed before I started writing were great, but every one lacked at least one important feature. If the authors were psychologists and teachers, they weren’t fully comprehending or directly addressing the sensory and motor aspects of a very physical skill. Oops.

OTs are always aware of the cognitive and social/behavioral components of activities of daily living, but we also have a solid background in physiology and neurology as well. That makes us your go-to folks for skills like toilet training. And that is a major reason why The Practical Guide is so helpful to the frustrated parents of children with SPD,autism, Down Syndrome, Ehlers-Danlos Syndrome, and a host of other diagnoses that result in delays or difficulties with muscle tone and potty training independence. It explains in detail how low tone creates sensory, motor, and social/behavioral problems, and how to address them. Knowledge is power, and knowledge leads to independence.

The other huge difference is that developing consistent sensory-motor-behavioral routines matter more for these kids. Tone isn’t a constant, as anyone with a child that has low tone knows all too well. Fatigue, illness, even a very warm day; these all make kids less stable and can even reduce their safety. Having a really solid routine makes movements easier to execute and more controlled when situations aren’t perfect. Kids with normal muscle tone can shift their behavior on the fly. They can quickly adjust and adapt movement in ways that children with low tone simply cannot. It isn’t a matter of being stubborn or lazy. Kids with low tone aren’t going to get the sensory feedback fast enough to adjust their motor output.

Good motor planning on a “bad day” occurs for these kids when they have well-practiced routines that support safe and smoothly executed movements. What makes the difference isn’t intelligence or attention. It is recalling a super-safe routine effortlessly. This is completely attainable for kids who have speech or cognitive issues as well as issue with low tone and instability. It may take them longer to learn the routine, but it pays them back with fewer accidents and fewer tears.

To learn more about my book, The Practical Guide to Toilet Training Your Child With Low Muscle Tone, visit my website, tranquil babies.com, or view it on Amazon.com!ferris-wheeltai-jyun-chang-270109

Child Writing Too Lightly on Paper? It Might Not Be Hand Strength Holding Him Back

cindy-bonfini-hotlosz-354736-unsplash

If your child barely makes a mark when he scribbles or writes, most adults assume that grasp is an issue. Today’s post suggests that something else could be the real reason for those faint lines.

Limitations in postural and bilateral control contribute far more to lack of pressure when writing  than most parents and teachers realize.  For every child in occupational therapy that is struggling to achieve good grasp, I see three whose poor sitting posture and inability to get a stable midline orientation are the real issues.

Think about it for a minute:  if you sat with your non-dominant (not the writing hand) hand off to the side and you shifted your body weight backward in your chair, how would you be able to use sufficient force on a pencil or a crayon?  Try this right now.  Really.  You would have to focus on pressing harder while you write and hope your paper doesn’t slip around.  That would require your awareness and some assessment of your performance.  Children don’t do “awareness and assessment” very well.  That ability comes from frontal lobe functions that aren’t fully developed in young children.  But they can learn where to place their “helper hand”, and that sitting straight and shifting forward is the correct way to sit when you scribble or write.

If a child has sensory processing or neuromuscular issues such as cerebral palsy, Ehlers-Danlos Syndrome or Down Syndrome, achieving adequate postural stability may take some effort on the part of the therapists and the teacher.  Well worth it, in my experience.  There are easy hacks that help kids; good equipment and good seating that won’t cost a fortune or inconvenience the class.  Every child can learn that posture is important for writing.  But the adults have to learn it first.  Kids take their cues from what adults appear to value, and if they figure out that they are allowed to slump or lean, they almost always will.

I am doing a lecture on pre-writing next week, and I intend to make this point, even though the emphasis of my lecture is on the use of fun drawing activities to prepare children to write and read.  Why?  Because it may be the only time these preschool teachers hear from a pediatric occupational therapist this year, and I want to make a difference.  Understanding the importance of postural control in pre-writing and handwriting could help struggling kids, and make decent writers into stars!

 

For more information, take a look at For Kids With Sensory Issues and Low Tone, Add Resistance Instead of Hand-Over-Hand Assistance and Better Posture and More Legible Writing With A “Helper Hand”.

rawpixel-653771-unsplash

Is Your Gifted Child Also Your Most Strong Willed Child?

taylor-smith-Mw9TO8Wbz8A-unsplashParents of some gifted children know that this gift comes with more than a quick intellect.  It can come with a will of iron and incredible emotional range.  Gifted children can be expansively happy one moment, and intensely sad the next.  No, it isn’t bipolar disorder, and it probably isn’t ADD (gifted kids are misdiagnosed with both at an alarming rate).  Gifted children have an emotional capacity that often matches or exceeds their intellect.  Here is why:

Their brains are different.  They are qualitatively different, meaning that they notice, synthesize, and experience information differently, not just “more” or “more like an older child” than other children.  Their brains work differently, but they are trying to comprehend how others understand situations and why they behave as they do.  When they cannot get where other people are coming from, or when they insist on the world working their way, things can get explosive.

Yes, the same brain that allows a 4 year-old to read chapter books to her preschool class without having been taught to read is also feeling and connecting emotional information differently from her peers as well.  She can’t “get over it” when arbitrary rules do not allow her to take materials out of the reference section of the library, or when she isn’t allowed to finish watching a documentary on sea creatures because you have to take her brother to swim practice.  Functional imaging studies have been reported to see much more diverse brain activity in gifted individuals during simple tasks.  They light up like Christmas trees because they are incredible thinkers.

All that thinking can get them in trouble with the day-to-day world of rules and good behavior.

The amazing brains of gifted children are understood to have what one researcher calls “overexcitabilities”.  Only one is intellectual excitability.  The others include emotional/empathetic, motor, and sensory excitability.  This can lend itself to some explosive tantrums in toddlerhood and even disabling complaints of clothing or lights being far too irritating and distracting.  The same child that can explain to you how the electoral college works can be sidelined by the scratchy tag in his shirt!

The drive for mastery and perfection is a heavy burden for the gifted child.  Their perfectionism comes from the ability to imagine what the ultimate outcome could be, not an anxious concern with being judged or being found inferior.  It is coming from an internal demand to create what their amazing brain can conjure.  This isn’t “fixable” with meditation or deep breathing.  Giving them information about where this drive originates is helpful, as are clear boundaries of time and resources.  Learning to handle the drive for perfection is a goal for most gifted people, and the learning should start early.

Gifted children with strong wills aren’t always appreciated for their determination and their energy.  They balk at instructions, refuse assistance when they need it, and aren’t easily distracted from their desires.  I think that the first step in handling the emotional over excitability of a gifted child is to accept how difficult it is as a parent or a teacher, and then learn about how this aspect of giftedness works.  From there it is a matter of building skills in self-control and social/communication skills.  Read Want Better Self-Regulation in Young Children? Help Them Manage Aggression for some ideas on dealing with aggressive behavior.  Gifted children do not have to get their way because their IQ is in the stratosphere.  They still have to avoid aggression, including verbal aggression (something teenage gifted kids are virtual masters of).  Read Why Gifted Children Aren’t Their Teacher’s Favorite Students…. and  Is Your Child Bright or Gifted?  to understand some of the shadow sides of giftedness.

My perspective is that gifted children need more help with social skills since they often have such disparity between their cognitive capacity and their emotional abilities.  Feeling responsible for the world’s troubles doesn’t mean that you are, and knowing that the rules are arbitrary doesn’t mean you have the authority to change them.  Parents who teach their children how to navigate these problems will give a huge gift to their children.  Children need to understand that they aren’t bad, but they are different.  And their behavior is connected to the way their brain works and always will work.  They need to navigate their path within the wider world, making friends and dealing with authorities that do not see things in the same way.  The world may not always understand gifted people, but if gifted people understand themselves, it could be a happier and calmer place for everyone.

rochelle-brown-501488-unsplash

Is Your Sensitive Child Gifted As Well?

Happy New Year!  The topic of sensitivity (in all it’s expressions) in young children isn’t new to this blog, but the correlation with giftedness hasn’t been a part of my other posts.  It is today.

Sensitivity is common in gifted toddlers and preschoolers, and sensitivity is ubiquitous in young children with diagnoses such as ASD and SPD.  Could you have both?  Sure.  Could you have neither, and just have a very sensitive little soul who avoids socks with seams and still can’t spell their name at 5?  Sure.  Seeing the pattern of sensitivity that gifted children can express isn’t that easy, but it can make dealing with a young child so much easier when you understand the source and know how to support them.

Gifted children make mental and emotional connections that other children their age do not.  They see and feel the world differently.  They are still young children, without fully developed emotional regulation, and they bear the weight of all that they perceive.  It can  accumulate throughout the day and over time, and overtake them.  You can see more outbursts, more episodes of being overwhelmed, and more crushing waves of emotion.  Strong emotions are common with the gifted populations, and they can be more challenging during the toddler years.  Remember: not every aspect of brain development is advanced at the same level in gifted children.  In many ways, your 3 year-old who reads chapter books is still just 3!

Our brains do not have barriers, so emotional and cognitive floods will create sensory floods as well.  This is something that every adult can understand:  if you have had a fight with your partner, it is more likely that the bright sunshine will bother you a bit more, the TV will seem too loud, and the people in line at a store are crowding you a bit more than you’d like.  You are an adult, so you can take action to reduce your sensitivity (sunglasses, remote control, choosing a shorter line or leaving) but children cannot.  They do not even know what is making them uncomfortable.  And they often cannot put feelings into words, even if they can tell you all about every dinosaur or how tornadoes affect the planet.  Emotional maturity and expression is not always developing at the same amazing pace as cognitive skills in gifted toddlers and preschoolers.

What can you do to help a gifted and sensitive child?  The general methods to address  sensory sensitivity will be helpful for these children.  OT’s use a wide range of physical and behavioral strategies effectively, about which I will write about in more detail later this week.  Verbally gifted children may be able to comprehend an explanation of why they explode the way that they do, and they may even be able to help you create a plan to help themselves.  Loving your child isn’t enough, but accepting the entirety of who they are can go a long way to making life easier with your sensitive gifted young child.

I will be writing more about this topic in 2017, and hoping to expand my posts to an e- book and a few local lectures.  Please comment here, and let me know if there are specific issues with sensitivity and the gifted child that you would like to see posted!

 

 

Dressing Without Tears: Sensory-Sensitive Strategies That Work

marjorie-bertrand-eyzzqAQhcjI-unsplash

If your child has tactile (touch) sensitivity, getting them dressed can mean more than a chore.  It can mean tears.  Tags in shirts, “scratchy” jeans, and all that pulling of clothing over their face!  I know families that scheme for months to find clothes that their child will wear to a wedding or buy clothes online because trying on clothing in a store is a nightmare.

The low-hanging fruit:  soft tees and sweatpants/shorts are the most tolerated clothing for kids with sensitivity.  Even these have some caveats.  Clothing that is too loose creates movement while worn, and long cotton sleeves are a good example of irritants for sensitive kids.  Get a good fit and forget about buying things large for growth.  Comfort and compliance now is absolutely key.

Pressure garments and compression underwear:  I have never been a fan of Theratogs.  They are expensive and awkward for most kids.  When they work, they are amazing, but there are lower-tech and lower-priced possibilities.  UnderArmor underwear fits smoothly  and creates a bit of comforting pressure.  Even the lycra sunsuits that kids wear to the beach can be worn under clothing in cooler conditions.  Children who are not toilet-trained are the hardest, since you need to pop off pressure garments to change them.  This could be a great reason to begin pre-training and make your potty training plan.  Take a look at Waiting for Toilet Training Readiness? Create It Instead! for some ideas.

Don’t forget that all sensory responses have a behavioral component.  I am not saying that there isn’t a neurological reason for a child’s discomfort.  Sensory sensitivity is real.  The behavioral piece is that responses can be diminished or increased by experience.  All experiences.  Children with mild to moderate sensitivity can react less when the fear and the novelty of wearing clothes is diminished.  How is that done?  Depends on the child, but short periods of wear that happen frequently and are not forced but are rewarded can transform a child.  Having control over which button-down shirt he wears for 3 minutes, or which video he gets to watch that is only available while wearing “the shirt”, can really make a difference.  So much of tactile sensitivity is anticipatory fear and feeling trapped, that when he doesn’t feel trapped and doesn’t fear it, tolerance can develop.  Parents have to be firm and loving, and kids can expand their tolerance.

Try the Brushing/Joint Compression program.  The one I use is the Wilbarger Protocol, developed by an amazing occupational therapist, Pat Wilbarger.  I was lucky enough to learn directly from her as a young therapist.  It works, but it has to be done correctly and it has to be understood.  After about 10 years, I almost stopped teaching this technique because it had turned into a game of “telephone”, in which parents would show me what a previous OT had taught them.  It looked only slightly like the protocol that Pat taught me directly.  A poorly executed protocol can actually make a child more sensitive.  It was awkward to tell parents that they had been taught incorrectly.

Learn this technique correctly,  and make sure that your therapist can explain the neuroscience behind it.  Have your therapist explain the gating theory of sensory modulation and the reasons that you don’t brush the abdomen or do neck compressions.  That way you know you are getting the real deal.

Is your child hypermobile?  Children with ligament laxity can have difficulty dressing too.  They just don’t have the stability even if they have the strength, to pull up their clothes and fasten garments.  Read about how your therapists can help you:  Hypermobility in Young Children: When Flexibility Isn’t Functional

taylor-smith-Mw9TO8Wbz8A-unsplash