Category Archives: technology

Want A Stronger Pencil Grasp? Use a Tablet Stylus

The trick? They need to use a short stylus and play apps that require primarily drag-and-drop play. Stop them from only tapping that screen today, because tapping alone will not make much of a difference in strength and grading of force.

Why will drag-and-drop play work? The resistance of the stylus tip on the screen builds strength and control at the same time. They gain control as they get the immediate feedback from game play. Too much force? They get stuck and can’t move the styluses the target. Too little force? Again, the target doesn’t move. Could they revert to a fisted grasp and accomplish this? Sure, but that is exhausting, and you are within view of them anyway….right?

For this to work, young children need supervision, but not helicopter supervision. And they need to know that how they hold any utensil matters to you. My best approach to build grasp awareness is to appeal to their desire to be older. Tell your child that you have been watching them, and you believe they are ready to hold a stylus like an older kid. Oh, and you can explain to them how to hold the stylus the easy way. They just have to watch your example and play some games for practice. Yup, you ASK them to play on a tablet!

Best drag-and-drop games for young children? I like the apps from Duck Duck Moose, especially the Trucks and Park Math. Every app has some tapping, but you can select and “sell” the games that require drag-and-drop. There are apps that little girls can play to dress up princesses, mermaids, etc. Pick the ones where they have to drag the items over to the characters. Same with wheels on trucks, shapes into a box, etc. The Tiny Hands series of educational apps have a lot of drag-and-drop play.

Finally, mazes are wonderful, and so are dot-to-dots that require drag-and-drop play.

Have a really young child, or a child who struggles to keep their fingers in a mature grasp pattern without any force? Then apps that require just a tap are fine. I set the angle of my tablet at various heights (my case allows this) to prompt more wrist extension (where the back of the hand is angled a bit toward the shoulder, not down to the floor). When a child’s wrist is slightly extended, the mechanics of the hand encourage a fingertip grasp without an adult prompting them.

Try drag-and drop play with a stylus on your tablet today, and see if your child’s grasp strength starts improving right away!

Hypermobility in Young Children: When Flexibility Isn’t Functional

Your grandma would have called it being ” double jointed”.   Your mom might mention that she was the most flexible person in every yoga class she attended.  But when extra joint motion reduces your child’s performance or creates pain, parents get concerned.  Sometimes pediatricians and orthopedists do not.

Why would that happen?  A measure of flexibility is considered medically within the norm for children and teens.  Doctors often have no experience with rehab professionals, so they can’t share other resources with parents.  This can mask some significant issues with mild to moderate hypermobility in children.  Parents leave the doctor’s office without a diagnosis or advice, even in the face of their child’s discomfort or their struggles with handwriting or recurrent sports injuries.  Who takes hypermobility seriously?  Your child’s OT and PT.

Therapists are the specialists who analyze functional performance and create effective strategies to improve stability and independence.  I will give a shout-out to orthotists, physiatrists and osteopaths for solutions such as splints and prolotherapy.  Their role is essential but limited, especially with younger children. Nobody is going to issue a hand splint or inject the ligaments of a child under 5 unless a child’s condition is becoming very poor very quickly.  Adaptations, movement education and physical treatments are better tolerated and result in more functional gains for most middle and moderately involved hypermobile children.  Take a look at Hypermobility and Proprioception: Why Loose Joints Create Sensory Processing Problems for Children to understand more about what an OT can do to help your child.

Low tech doesn’t mean low quality or low results.  I have done short consults with children that involve only adaptations to sitting and pencil choice for handwriting, with a little ergonomic advice and education of healthy pacing of tasks thrown in.  All together, we manage to extend the amount of time a child can write without pain.  Going full-tilt paperless is possible when pain is extreme, but it involves getting the teachers and the district involved.  Not only is that time-consuming and difficult to coordinate, it is overkill for those mildly involved kids who don’t want to stand out.  Almost nothing is worse in middle school than appearing “different”.  A good OT and a good PT can help a child prevent future problems, make current ones evaporate, or minimize a child’s dependence and pain.

Hypermobile kids are often bright and resourceful, and once they learn basic principles of ergonomics and joint protection, the older children can solve some of their own problems.  For every child that is determined to force their body to comply with their will to compete without adaptation, I meet many kids that understand that well-planned movements are smarter and give them less pain with more capability.  But they have to have the knowledge in order to use it.  Therapists give them that power.

Parents:  please feel free to comment and share all your great solutions for your child with hypermobility, so that we all can learn from YOU!

Is your hypermobile child also struggling with toilet training or incontinence?  Check out Low Tone and Toilet Training: Learning to Hold It In Long Enough to Make It to The Potty  to gain an understanding of how motor and sensory issues contribute to this problem, and how you can help your child today!

Will White Noise Harm a Newborn’s Hearing?

This question doesn’t come up as often as it should when I do Happiest Baby on the Block consultations.  The short answer is that common sense goes a long way to protecting a newborn’s hearing.  The longer answer is that understanding sound conduction and newborn development will help parents use white noise confidently.  Here we go:

White noise, selected carefully and used with some knowledge, can be a powerful way to calm newborns and it can be a go-to sleep cue for the entire first year.  Babies that recognize white noise as a cue that it is time to sleep are easier to calm when the going gets rough.  When that first cold, first tooth, or sibling tantrum comes along, the baby who calms automatically with white noise will be easier to soothe.  The gift that keeps on giving!  Is it addicting?  Only as much as your cozy pajamas are on a chilly night! Are Babies Addicted to White Noise? Yes….and No

Sound characteristics for safety and effectiveness are volume and pitch.  High pitched sounds are the more dangerous type, especially when used at high volume and close to a sleeping child’s ears.  High pitched sounds are also less effective at calming.  Examples of high and low pitched sounds?  Think about the difference between a whistle (high) and a vacuum (low pitched but loud) or water from a shower head (low pitch and moderately loud).  Everyone has heard stories of babies who stopped screaming only if they were next to the clothes dryer or when someone ran the vacuum.  Those newborns aren’t excited about housework; the rumbling low frequency sound at a moderate volume helped calm them.  Thank goodness that Dr. Karp’s Happiest Baby organization sells while noise CD’s and apps that replicate those calming sounds.  I like to vacuum, but not that much!

Babies who scream can easily reach 100 dB (decibel ). That is as loud as a lawnmower!  To use white noise to help a screaming baby calm down, you are going to have to turn up the volume temporarily to about 80-90 dB for white noise to have an effect.  Remember, I said tem-po-rarily.  Once a baby is not screaming, but is still fussy, it is time to lower the volume down gradually to a soft shower level. It is not recommended to use white noise at the volume level above 70dB all night long.  

How close should the sound source be to the baby?  It depends.  Obviously if it too far away, the effect of sound is diminished to the point where it does no good at all.  You will realize that quickly as you watch your newborn continue to scream and fuss.  Too close is not acceptable either, as the volume of sound will be too high.  By the way, Dr. Karp encourages families that want to use a cell phone for white noise to put it on Airplane Mode to diminish the amount of radio waves from the phone.  Most phones have tinny speakers that don’t deliver great low pitched sound anyway.  The most accurate way to know that the sound is a safe distance is to download a decibel meter app or buy a free-standing meter.  Place it next your child and adjust the volume so that the level for an all-night session is 65-70dB.  That is about the level of lively conversation, and a safe level for full-term babies.

Should you use white noise all day and all night?  Absolutely not.  Babies need white noise to sleep and calm, but when awake and interacting, they need to hear your loving voice, experience the quiet stillness of a peaceful home, and listen to the wonderful sounds of nature and family!

 

 

Take Notes with a Paper Notebook, But Only if You Can Write Quickly

Research in Psychological Science last spring and in an article in The Chronicle of Higher Education suggests that writing notes by hand requires the listener to synthesize a lecture more effectively than laptop note-taking.  Three studies showed that testing immediately after a lecture and even a week later still saw improved retention of conceptual information when students wrote notes rather than used a laptop during a lecture. No differences were noted in factual retention.  Evaluation of the  actual notes revealed that laptop users were more likely to record the lecture verbatim, even when they were instructed to take notes selectively.  They concluded that there was a subconscious tendency to transcribe a spoken lecture when keyboarding.  Students who used paper were more likely to process, reframe and synthesize the lecture during class.

Before you run out and by a tablet with a stylus (BTW, my new Microsoft Surface 3 and it’s pen is amazing for this purpose), you might want to think about how we used to do it old school.  It is very difficult to take notes quickly while mentally synthesizing the lecture.  You have to have two skills:  fast, readable handwriting and the ability to process information and reframe it in words that are meaningful to the listener.  Teachers do a much better job at instructing children to think critically and synthesize information than they do at teaching them to write legibly and quickly.  This research suggests that they have to teach both skills.  To paraphrase the movie “Jaws”, you are gonna need a bigger boat (of skills).  Teachers need to teach cursive writing.

The fastest method of handwriting is to combine the easy cursive letters and connections such as “he”, “el”, “ff” and “er” with print letters that substitute for tricky cursive connections such as “s” and “bb”.   There are more examples, but you get the general idea.  Anyone who is fluent in writing both styles will soon blend combinations into their own pattern of faster writing.  A child who has had poor handwriting instruction, or whose teachers see no reason to use cursive, will never have the skills to write in this manner.  Children who only print will soon realize that using printing alone is slower than keyboarding.  That child will grab a laptop as soon as possible and take down every word. They have not been given a choice.

It is interesting that the researchers didn’t mention the level of legibility of note-taker’s handwriting.  It may not matter as much as the experience of critical thinking and recording thoughts on paper. That would be an interesting study.  The benefits of the process of reframing and recording synthesized material is a message to parents and teachers to reconsider the power of the pen and the pencil.

Peekaboo Apps: Fun Learning Choices for the Toddler Techies

One of the best app designers for very young children (for whom short periods of screen time with an interactive adult is always the way to go) are the folks who make the Peekaboo series.  They have created a handful of apps (Peekaboo barn, vehicles, fridge, ocean) that use sharp but simple graphics, sound effects that entertain but do not overwhelm, and these apps can be used by very young children or developmentally delayed children with ease.  You can select a continuous shuffle, or have the app end when your child has viewed all the pages.  I have not downloaded the zoo app, but I just might have to do so.  The others are that good!

Each app is designed slightly differently, and I review them below based the level of physical ability needed to activate the screen and the interactive demands of the game.

Peekaboo Vehicles is a strong winner for boys who love cars but have difficulty with accurate hand control (or for very young gear heads).  Your child sees a cloudy screen and hears the quiet roar of a vehicle.  Tapping once will reveal the hidden vehicle, and another tap with drive it away, bringing back the clouds.  That’s it, nothing more.  Sometimes you don’t need more activity on the screen to stimulate learning.  You can talk about the picture, name all the items and colors, and stimulate language by pairing the reveal and the send-off with target words such as “open, go, bye”,etc.  You can chose an American or a UK pronunciation.  The sound effects are simple and familiar to most children, and the visual complexity is moderately stimulating.  The focus is on the vehicle.

Peekaboo Barn and Peekaboo Fridge show either a red barn or a kitchen, and your child hears the animal or the animated food make a noise to entice them to open the centrally placed doors.  Peekaboo Fridge shakes the fridge door slightly, for a nice visual cue.  Touching the screen outside of the target will not activate the screen, leading the child to aim carefully and reducing random tapping. When the door(s) open, you see the animal and hear his bark/moo/oink, or see the food with a funny little sound. The app allows a few seconds for the child to identify the item, then speaks the name of the animal or food.  Tapping the screen again will close the door.  A new sound/movement will entice your child to tap again.  The barn animals make realistic sounds, but some children with auditory sensitivity have been startled unless the sound level is low.  Peekaboo Fridge sounds are  very subtle and quiet.  Again, plenty of opportunities to promote language with familiar animals and foods. The graphics are simple and colorful, making it easy for a young child to identify familiar details such as the sun or the clock. Your child cannot close the doors until the app has said the name of the animal or food, which again avoids the overstimulation that occurs when a young child wildly taps the screen without control or focus.  During the holiday season, the animals in Peekaboo Barn are wearing colorful hats and the barn has holiday lights and snow.

Peekaboo Ocean is more complex, but also more entertaining.  An object is just peeking above the waves, and only a direct tap on that object will reveal it.  All of the target items have an interactive component, so touch the full object when it appears.  The jellyfish are the least active (if you have met one, then you know that is a good thing!) and the mermaid actually speaks.  It is adorable when the child speaks back to her!   Not all of the other animals and objects in each screen will respond.  The expanding sea star and the spinning octopus and her brood are a delight to young children.  Most (but not all) sound effects are subtle but engaging.  Children with sensory processing issues or ASD can be startled by sounds that are not familiar, such as the submarine horn or the whale.  They may prefer to have the sound muted.  Your child progresses to the next page by tapping the arrow at the top right hand corner of the screen.  It is not very obvious to the youngest children, so an adult may need to advance it.  This can be an advantage if you would like to keep a child focused and interactive for longer periods.

Enjoy the look on your child’s face as they navigate the land of peekaboo!

Toddler Apps That Make Tiny Hands and Tiny Minds Work Together!

One of my favorite app designers are the folks at Tiny Hands.  They have a suite (but you can buy apps separately and get free mini trials) of apps for the 2-5 set that are progressive in challenge but consistently high in fun.

Since I am always looking for positive (read: active) tablet use, I like the way these apps require matching, categorization, counting or visual-percpetual skills to be rewarded at the end with a cute character suspended on pop-able balloons.  The graphics are very simple, and an over-excited toddler cannot tap themselves through.  They have to think.  Themes reflect topics that toddlers can recognize and nothing controversial.  There are no warring ninjas or exploding bombs.  But there are plenty of animals, vehicles, and even some music.  Levels of play are indicated, but the child is not restricted from trying higher levels.

As an occupational therapist, I love using the app crayon or the app stylus for these games.  The drag-and-drop function builds hand strength and control without a child realizing that they are doing so.  It is just so much fun.

Tiny hands gets tiny minds working too!

LEGO Apps That Your Child Really Wants to Play

Toddlers and preschoolers love tablets.  Wouldn’t it be terrific if parents could download apps that actually developed skills instead of just kept children happy?

The LEGO Duplo apps series for toddlers will enchant kids and their parents.  Occupational therapists like them because they develop perceptual and ocular control skills, as well as muscle strengthening when a child uses a stylus to accurately drag and drop objects in all planes of motion on the screen.  The five apps (train, zoo, circus, food, and ice cream) are simple enough for a 2.5 year old to navigate independently, and creative enough to keep playing without boredom on a cross-country flight.  A child moves objects around the screen or taps on them to build and drive a train, visit a zoo and deliver a present to a lion, serve food, or run a circus.  Children can make choices that result in a wide variety of outcomes that extend play and produce a sense of mastery.  Younger toddlers cannot wildly tap or move items accidentally, thus improving their focus and preventing meltdowns.  The apps are available for both the Apple and Android platforms.

My favorite of the five apps is the train, due to it’s entertaining sound effects and the wide appeal of trains for both boys and girls at this age.  But they are all fun and engaging for both children and parents.  Oh, did I mention that they are free?