Category Archives: toddlers

Want Your Child to Show Hand Preference (Righty/Lefty?) Where You Place Their Spoon Matters

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I get a lot of questions about this issue, based on my experience as a pediatric OTR.  Starting at 12 months, some children show a strong hand preference and never look back.  Other kids are switching hand use long after 4.  Without the existence of disorders that directly affect hand dominance such as orthopedic disorders, cerebral palsy, or untreated torticollis, hand dominance is hard-wired and emerges naturally.  But there are situations in which it is delayed or incomplete long after the typical window of skill development.

Here is what can be happening, and here is what you can do as a parent or a therapist:

Hand dominance only emerges with the development of refined hand control and the child’s awareness that they need more skilled control for an activity.  I tell parents that I can pick up my coffee cup with either hand to drink, but that doesn’t make me a lefty.  If you paid me $100, I probably couldn’t thread a needle with my left hand.

Children that aren’t practicing refined skills like feeding or assembling blocks, or even intent on picking up every darn piece of lint on the carpet…they don’t need refined grasp, and they probably will not demonstrate hand dominance on time.  Kids that are scribbling wildly but haven’t tried to draw a circle with closure ( a 36-month skill, BTW) also have no need to develop dominance.  The self-starter, the baby and toddler that watches you intently and decides to learn all these skills?  They won’t need much help.  But the child who avoids challenge or gets help because it is easier and faster for an adult to feed them or help them build a tower?  They may lag behind in hand development.

Some kids are very tuned into adult actions, and copy the hand that a parent or teacher uses.  These are the children that are great mimics.  They can see that you are using your right hand, and even if they naturally grab with their left hand, they transfer objects into the same hand you are using.  Adults are naturally inclined to assume dominance as well.  I cannot count the number of times I absent-mindedly handed a pen to a left-handed parent into their right hand.  If you do that to a child under 5 , they assume that you want them to use that hand, and will struggle on.  This is where spoon placement matters.  I encourage parents to place the utensil in the center of the placement or tray, and watch which hand (both of the child’s hands must be free) their child chooses over many trials.

If a child is inconsistent but clearly uses their left hand more often, placing their spoon on that side of the tray should boost use, and with skilled use comes more skill and awareness.  I never pull objects out of a child’s hand.  I don’t need to.  They will drop their crayon or spoon frequently enough for me to have another chance to offer it back to them.

What if I (or a parent) picked wrong?

Dominance isn’t that easy to alter.  Ask your grandmother what the nuns in Catholic school did to alter dominance in lefties (it was considered “the devil’s hand”, and what they did wasn’t pretty).  Children will eventually simply transfer their spoon over to the other hand.

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How To Help Your Toddler Hold a Spoon

hal-gatewood-e3Y23rtVk8k-unsplash.jpgHolding a spoon or fork isn’t an intuitive skill for children.  Neither is assisting another person, of any age, to self-feed.  Parents really have struggled with this issue, and there must be many more out there who are struggling still.  This post is intended to help both parties be more successful.

Young children use a “gross” or fisted grasp to hold a utensil; see the photo above.  This continues until 3-4 years of age, when they have the hand strength and dexterity to use a mature grasp that incorporates the fingertips and thumb:

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Trying to force a toddler to use a mature grasp is almost impossible, and allowing a toddler to use an atypical grasp is also unacceptable.  It is inefficient and frustrating.  The amount of spillage almost always makes parents decide to feed a child that should be learning to feed themselves.

Parents need to teach utensil grasp, and support it with the right tools and assistance until self-feeding becomes easy and natural to a child.  Here is how to make that happen:

  1. Have the right tools.  Once a child is old enough to try to self-feed, they need toddler utensils.  Adult utensils have thinner, longer shafts.  This makes it much more difficult to hold.  Not impossible, just harder.  Make life easier on both of you and invest in toddler spoons and forks.  Infant feeding spoons have a tiny bowl and a very long shaft.  That is because they help scoop food from a jar and reach a baby’s mouth:  adults are the intended users!  Do not give them to your toddler.  They are harder for toddlers to use.  Shallow plastic bowls with a non-skid base are very helpful.  OXO sells the best bowls for this purpose, and since they are well-designed, you don’t have to get rid of them as kids get older.  They will be attractive and useful for years to come.
  2. Provide the right assistance.  In the very beginning, I encourage parents to load a fork with a safe food such as a cooked piece of carrot.  Food on a fork doesn’t fall off as easily.  They place the fork in the child’s hand and assist them in bringing it to their mouth.  Adults need to “steer” the utensil until a child develops the motor control sequence to successfully get food on the utensil.  Parents should be holding the end of the handle so that the child can place their hand in the center of the handle shaft.  Children will grasp the end of the spoon if the parent uses any other hand placement.  Young children will not automatically hold a utensil correctly.  It is the parent’s job to know how to present the utensil for grasp.
  3. Make it fun.  Feeding shouldn’t be difficult or unpleasant.  I wrote a popular post on the best way to make learning to use utensils enjoyable Teach Spoon Grip By Making It Fun And Sharing a Laugh With Your Child .   This works even with children with ASD and SPD.  In fact, it might be the best way to get kids with these diagnoses to learn to use utensils.  There is an opportunity to develop social skills and turn a daily living skill into a fun game!

How To Improve Posture In Children With Low Muscle Tone… Without a Fight!

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With pediatric occupational therapy going on at home using parents as surrogate therapists, it isn’t helpful to ask a parent to do too much repositioning of children with low tone.  First of all, kids don’t like it.  Second, kids really don’t like it.

I have never met a child that enjoys therapeutic handling, no matter how skilled I am, and I don’t think I ever will.  They don’t know why we are placing their hands or legs somewhere, and they tend not to like to be told what to do and how to do it.  The best you can hope for at times is that they tolerate it and learn that therapists are going to be helping them do what they want to do For Kids With Sensory Issues and Low Tone, Add Resistance Instead of Hand-Over-Hand Assistance.

Leaving a child in an awkward and unstable position isn’t the right choice either.  They are going to struggle more and fail more when out of alignment and unsteady.  If you know this is going to happen, you can’t let them stay that way because you also know that this will blow back in your face in the form of frustration, short attention span, and children developing a sense that whatever they are doing or whomever they are doing it with is a drag.  A real drag.

So how can you improve the posture of a child with low tone without forcing them physically into a better position?

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Potty Training in the COVID-19 Age

 

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Parents are staying home with their toddlers and preschoolers now.  All day.  While this can be a challenge, it can also be the right time to do potty training.

Here’s how to make it work when you want to teach your toddler how to “make” in the potty:

  1. You don’t have to wait for readiness.  What you might get instead is a child that has lost the excitement of being praised by adults, and fears failure more than seeks praise or rewards.  If that sounds like your child,  quickly read Waiting for Toilet Training Readiness? Create It Instead!
  2. Have good equipment.  If you don’t have a potty seat that fits your child or a toilet insert and a footstool that is stable and safe, now is the time to go online shopping for one.  Without good equipment, you are already in trouble.  Children should be able to get on and off easily and not be fearful of falling off the toilet.  If you are training a preschooler and not a toddler, you really need good equipment.  They are bigger and move faster.  Safety and confidence go hand in hand.
  3. Have a plan for praise and rewards.  Not every child will want a tiny candy, but nobody should expect a new toy for every time they pee in the potty.  Know your kid and know what gets them to try a new skill.  Some children don’t do well with effusive praise Sensitive Child? Be Careful How You Deliver Praise , so don’t go over the top if this is your kid.
  4. Know how to set things up for success.  If your child is typically-developing, get Oh Crap Potty Training by Jamie Glowacki, because she is the best person to tell you how to help you be successful.  She even has a chapter just on poop!  If your child has hypotonia or hypermobility, consider my e-book, The Practical Guide to Toilet Training Your Child With Low Muscle Tone.  It is inexpensive, available on Amazon and Your Therapy Source, and gives you checklists and explanations for why you need to think out-of-the-box to potty train these kids.  You don’t leave for vacation without a map.  Don’t wing this.  Just don’t.
  5. Build your ability to calm yourself first.  Exactly like on an airplane, (remember them?  We will get back on them eventually) you need to calm yourself down in the face of refusals, accidents and tantrums.  You are no good to anyone if you are upset.  Read Stress Relief in the Time of Coronavirus: Enter Quickshifts and Should the PARENTS of Kids With Sensory Issues Use Quickshifts? for some ideas.

Looking for more information on potty training?  I wrote an e-book for you!

The Practical Guide to Toilet Training Your Child With Low Muscle Tone was my first e-book.  It is still my best seller.  There is a reason:  it helps parents and kids succeed.  This unique book explains why learning this skill is so tricky, and it gives parents and therapists detailed strategies to set kids (and parents) up for success!  Understanding that the sensory and social-emotional impacts of low muscle tone are contributing to potty training deals is crucial to making this skill easier to learn.  I include a readiness guide, strategies to pick the best equipment and clothes (yes, you can dress them so that they struggle more!), and how to move from the potty seat onto the adult toilet.

It is available on Amazon and on Your Therapy Source, a great site for materials for therapists as well as parents looking for homeschooling ideas.

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Is Your Toddler Home From School Because of COVID-19? Save Your Sanity With Fun Routines

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Many families have toddlers that are not attending daycare or preschool now.  They are at home.  All day.  They are off their schedules, and sometimes seem off their rockers!  Here are some ideas to help their parents retain their sanity:

  1. Create a routine for them.  This means that they get snacks at a certain time, outdoor play at a certain time, look at books, take a nap, listen to music, etc.  all in a predictable sequence.  Paint rocks, tear up scrap paper and glue it onto a bigger piece of paper, etc.  Crafts are fun and they can be cheap.  You don’t have to reproduce the school routine, you just have to be consistent about your home routine.  They will learn to anticipate what comes next, with all the calmness that consistency provides.
  2. Have some emergency items/activities.  Bake off some pre-made cookie dough, open up some new toy you saved for a special time.  It is special now!  Root through the back of the gift closet or the toy box and find something that is new or seems new.
  3. Turn on music and calm everyone down.  Music is powerful, and these days we need it.  Sing out and be silly.  You probably could blow off some steam too.  Consider using Quickshifts  Binaural Beats and Regulation: More Than Music Therapy if your child has sensory processing or low muscle tone.
  4. Make sure they get to move.  Every day.  Even if all you do is dance around the room, make it active.  Jump on pillows, log roll around safely, etc.  I treated kids in tiny NYC apartments, so I know it can be done.  It isn’t about having a lot of space.
  5. Reconsider the use of screens as rewards.  I know it works, but there is a price to pay after that initial quiet time.  Think carefully about what will happen when time is up, or when meals of bedtime come.  It could get ugly.  I have used screen activities in treatment, but NEVER EVER a reward, or even a consistent activity every session.  It is another fun thing we do that isn’t always available, and certainly not received by howling for it.  For apps that teach instead of entertain, read Screen Time for Preschoolers? If You Choose to Offer Screen Time, Make it Count With These Apps

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How to Get Children to Wash Their Hands

 

phil-goodwin-TxP44VIqlA8-unsplashThis season’s flu and viruses have parents and teachers wondering how to raise their game regarding infection control.  Washing your hands is one of the most important things anyone at any age can do to protect their health.  But small children aren’t always cooperative.  Getting them to wash their hands can be tough.

The families I work with know that I will not begin a session in their home, and especially that I won’t touch their child, without washing my hands first.  Not only is this to protect them, it is to model good practice for the kids.  Some children will ask me why I am washing my hands.  I always answer them by naming two things familiar to them.   I tell them that when I touch the outside of my car, my hands get dirty, and I don’t want to put dirt on our toys.

Cars and toys.  Most kids over 2 know what those two things are, and they know that one is not so clean, and the other one shouldn’t have dirt on it.  They get it.

But only a few parents insist that their child wash their hands before they begin working with me.  Some children want to share my sanitizer spray, and if a parent agrees, I will show them how to use it.

Now that we are facing both a serious flu season and a new virus, it seems like a good idea to provide suggestions to help parents out with hand washing:

  1.   Model good hand washing practices with a bit of drama.  You have to be a bit of a ham, and remember that kids need simple but dramatic explanations for information to sink in.  Something along the lines of “Oops, I FORGOT to wash my hands!  I will be RIGHT back as soon as I find some soap and water.  Do you know where it is?  Raise your vocal inflection, and use some gestures like stretching out your fingers.  Now say “That is SOOOOO much better.  My hands feel good and clean”.  Interrupt lots of things you are doing with a calm departure to wash your hands.  But make sure they hear you say where you are going and why.
  2. Get soap that they like.  Whether it smells good to them, has a character they love on the bottle, or is foamy or even tinted, soap they like is soap they will use.  Liquid soap is so much easier for young children to handle than bar soap.
  3. Make it easy.  They should be able to reach the water by using a spout extension, and possibly help you get the soap on their hands.  Paper towels that pop out of their holder ready to dry hands are easy to hold and the best way to avoid spreading germs.  Unless a cloth towel is changed very very frequently, it isn’t the cleanest choice. I treat a child whose mom is a cardio-thoracic surgeon.  There is a hands-free soap dispenser and a box of pop-up towels in her main floor powder room.  Enough said.
  4. Ask your partner and other people in the house if they have washed their hands when your child is paying attention to you and watching them respond.  Young children don’t take notice of these practices of others unless you point them out.  Hearing about who washed their hands, and hearing their enthusiastic replies, sends home the message that everyone washes their hands.  It is what we ALL do.
  5. Spin it positively.  Some children really become frightened if you message things about getting sick.  The message is to stay healthy.  Keep it that way.
  6. Make a habit of it.  Infection control staff know that making actions into habits is the best way to ensure safety.  Create new rules about washing hands throughout the day, and gently insist on them.  They will become habits.  Good ones.

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Sensory Processing and Colds: Nothing to Sneeze At!

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Here in the US, it is cold and flu season.  Most of my day is spend with kids recovering from some upper respiratory virus.  A few seem to have a continuous runny nose and cough.  They also have an increase in their sensory processing issues.  Is this connected, and if so, what can be done?

  1. Anything that affects health will make sensory processing harder.  Anyone, at any age, will struggle more when they don’t feel well.  If a child is super-sensitive, feeling ill will make them edgier and more avoidant.  If a child is a sensory seeker, that funny feeling in their head that changes when they flip upside down will probably make them do it more.  If a child is a poor modulator, and goes from 0-60 mph easily, they will have more difficulty staying in their seat and staying calm.
  2. Colds often create fluid in the ears.  This is a problem for hearing.  This is often a problem for speech and mealtimes.  It is also a problem for vestibular processing.  Fluid in the ear means that children are hearing you as if they are underwater.  Their speech may be directly affected.  They probably realize that biting and chewing open the eustacian tubes from the mouth to the ear, so they may want to chew more.  On everything.  They may also be unable to handle car rides without throwing up.  They may refuse to do any vestibular activities in therapy.
  3. Children sleep poorly when ill.  Anyone with sensory processing issues will struggle more when they are tired.  Young children cannot get the sleep they need and don’t understand why they feel the way they do.  Enough said.
  4. Spatial processing problems will get worse.  Being unable to use hearing to orient to the space and the people and objects in the room, children will roam around more, touch things more, startle more, stand still and look disoriented, and may refuse to go into spaces that are hard to process, like gyms or big box stores.  Uh-oh.

So what can you do as a parent or a therapist?

  • Understand that this is happening.  It is real.  It may not be a personality issue, a deterioration in their ABA program, or a problem with therapy.
  • Ask your pediatrician for more help.  There are nasal sprays and inhaled medications that can help, and some, like steroids, that can create more behavioral issues.  If your child needs steroids, you need to understand what effects they can have.  Saline sprays, cold mist humidifiers, soups and honey for coughs, if your pediatrician approves, are low-tech ways to help a child suffer less.
  • Alter your daily routine if needed.  Making less appointments, fewer challenges, and more rest could help.  Kids can be over-scheduled and under-rested.  Therapy sessions may have to be adjusted to both be less stressful and more helpful.
  • Your child may benefit from vestibular movement if they do not have an untreated ear infection.  Your OT can help you craft a sensory diet that moves fluid, but not if there is an infection.

Read more about sensory processing here: Does Your Child Hate Big Spaces? There is a Sensory-Based Explanation and Spatial Awareness and Sound: “Hearing” The Space Around You

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Young Children, Sensory Modulation, and the Automatic “NO!”

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Kids as young as 18 months can express their sensory processing issues with one word: “NO!!”  What appears to be a budding attitude issue or even oppositional defiant disorder can be a sensory modulation issue instead.

How could you possibly tell?

Well, if your child has already been diagnosed with sensory sensitivity or sensory modulation problems, you know that these issues won’t just make it harder to wear clothes with seams or touch Play-Doh.  These issues affect all aspects of daily living and create emotional regulation and biological over-activation issues as well.  Young children are learning how to express their opinions and separate physically and emotionally from their caregivers.  Saying “NO!” isn’t unusual for young kids (and a lot of older ones too!).  But refusals that make no sense can have a different origin.

So what is the giveaway?

When a child has an almost immediate “NO”, perhaps even before you have finished your sentence, and the reaction is to something you know they have liked or almost certainly would like, you have to suspect that sensory modulation is at play.  You usually sense when your child is trying to get your attention or get you activated.  This should feel different.

What do I do next?

You also need to respond in a specific way to test your theory that sensory issues are the root of the ‘tude.  Your response should be as vocally neutral and emotionally curious as you can manage.   “Oh, really….you said no…” is a good template.  Whether it is “no” to their fave food, show, toy or an activity.  You remove all criticism and encouragement from your voice.  You don’t want to fuel the refusal fire; you want to shut it off and see what is left in the embers of “NO”.

Now you need to wait for them to neurologically calm down.  Little brains are like old computers.  They take a while to reboot.  Look at the floor, wipe your hands, etc and wait a minimum of 15 seconds, probably 30, then ask again if they want a cookie, want to go out, want to play, to eat, or whatever.  The child who needed the primitive defensive part of their brain to go offline to allow them to use their budding frontal lobes may sweetly ask for what they just refused, or respond to your exactly identical request with a cheery “YES”.

Please try to have compassion for them.

It can seem maddening to do this all day long, and in truth, if you are, you need to learn how to work with an occupational therapist in order to learn powerful sensory treatment strategies that can get your child out of this pattern.  But your child isn’t jerking your chain when their behavior fits this pattern.  They are more likely a captive of their brain wiring.   Don’t let yourself react as if they are intentionally being difficult.  That day will come…..13 is just around the corner!

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How Dr. Harvey Karp Helps Kids AND Adults with Regulation Issues

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Can you do DBT with toddlers?  Well, Marsha Linehan probably would say no, but the Fast Food Rule and Patience Stretching come as close as you ever could!

Many child psychologists and psychotherapists are focusing on attachment theory and the problems of poor emotional regulation in children.  The rise of self-harm behaviors in teens and aggression in children as young as 3 can be related to difficulties handling emotions and experiences that increase arousal levels but never get resolved.

Not every child who throws their book down in frustration or slams their bedroom door needs to see a therapist.  But I do wonder how many of those teens that cut themselves, starve themselves or get suspended for putting their hands on a teacher or fellow student, actually needed Dr. Karp’s techniques when they were 3 or 4.  Maybe, just maybe, if they had been helped with Patience Stretching when they wanted that toy, or if someone had used the Fast Food Rule with them when they had a tantrum Use The Fast Food Rule For Better Attunement With Your Child, maybe they would be in better shape at 13.

Why?

Because these techniques don’t just work on the child.  They work on the adult using them as well.  And adults who can self-regulate raise kids who learn to do it too.

When I use Patience Stretching( Stretch Your Toddler’s Patience, Starting Today! ) with a toddler that wants one toy while I want them to work a bit longer on a therapy task, I am actually receiving the benefits of the technique as well.  I am both teaching and experiencing the reduction in frustration and the decrease in agitation as this strategy calms down the whole situation.  Oxytocin gets released when we calm down with a child, and adults need that hit as much as children do.  If we “go there” with an agitated child, we feel worse, even if we think we won because we have the power to deny or punish.  It doesn’t feel good to do either, but it also doesn’t feel good to give into a screaming child.  Not really.  Even the most permissive adult will say no to something dangerous, and then the child who is unfamiliar with hearing “no” will really explode.

The good news is that you don’t have to get an advanced degree to use Dr. Karp’s strategies.  You have to practice them so that your delivery is flexible and confident, but anyone can do it, not just therapists.  In fact, if these techniques don’t work well once you improve your delivery, that could be one way to decide that you need to consult a child specialist.

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Are You a Trauma Survivor AND the Parent of a Special Needs Child? This Can Help Make Life Easier

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First, let me say that trauma survivors can be among the most loving and active parents I work with as a pediatric occupational therapist.

How do I know they are survivors?  Some parents share their histories openly, and some aren’t aware of what their actions and words reveal.  Occupational therapists that have worked in psychiatry are particularly attuned to patterns of behavior that suggest a history of trauma.  And after therapy has gone on for a while and the therapeutic relationship blossoms, some parents wish to share more of their personal story with me.

Trauma survivors that had complicated pregnancies Can The Parents of Pediatric Clients Have PTSD? , have children with genetic disorders, or deliver children who develop developmental delays, come in all ages and social/support situations.  Some currently have a psychotherapist for support, and some have done a tremendous amount of therapy in the past.  Others may not even recognize that what they experienced in the past was traumatic, or that there is specialized help for trauma-related issues.

What they all have in common is the (mostly) sudden stressor of having a child with special needs, the seemingly endless daily demands of care, and the constant seeking/managing of medical, educational and therapy services.  Survivors of trauma may not realize that they aren’t alone with their feelings of distress, or that their child’s therapists can help them cope.

I wrote a post on how therapists can help a child’s siblings, How an Occupational Therapist Can Help The Siblings of Special Needs Children , but parents with trauma backgrounds can ask for and receive support from their child’s therapists as well:

The simplest way therapists can help you is to validate the real demands of care and give you some perspective on what other family’s lives are really like.  We are aware that we are asking parents to do home programs and obtain equipment and toys that facilitate development.  We also know that life is messy, and it is OK if you admit that you find it hard just getting through the day.  You can ask us if other parents go through the same things that you do, and you will find out that you might be doing more than we expect.

If you are having a rough period, ask us to give you just the ONE thing that would be the easiest to incorporate into your day that would help your child this week.  We won’t be offended.  You might be surprised to find that we know what those days/weeks/months feel like too.

Some parents who are trauma survivors are less likely to ask for a review or clarification of a technique or treatment when therapists give them instructions.  This can come from fearing criticism, having been taught not to question authorities, feeling judged by therapists they perceive as punitive authorities, and even being dissociative during their child’s therapy session.  “Spacing out”, forgetting, being confused, etc. are all possible dissociative responses.  Parents who are reliving a NICU nightmare or who are triggered and recall their own medical trauma or physical abuse may have a lot of difficulty learning to do treatments on their child that involve any level of restraint or distress.  This can be managed, but only if it is addressed.

Your child’s therapists have many different ways of holding and positioning a child, and different ways of administering a treatment technique.  You can express your discomfort in general terms or you can tell us that this is a trigger for you, and you can ask us to make things easier for you without having to tell your own story.  Asking for a few reviews of home programs is seen by most therapists as indicating interest in what we do.  We aren’t offended; we are flattered.

Some parents need to be out of the treatment room during a session for their own comfort, and that is also OK.  We like to share your child’s progress, and we welcome you into the session, but we understand if you need to have some distance.  Scheduling treatment at your child’s school or in a therapy center, rather than at home, may be easier for you.  Your child will still receive excellent treatment.

Trauma survivors can be extremely distressed when their child cries in therapy, or even while witnessing their child struggle to learn new skills.  This can bring up distressing childhood memories for them, some of which they may not fully recall or even connect with their responses to their child’s therapy session.

Therapists can be healing models for actively managing a child’s distress and expressing how they handle their own feelings when children struggle.  A parent that grew up in a punitive home may not have seen adults model healthy reactions to a child’s distress.

Therapists can teach you their techniques for grading challenge and providing support that reduces your child’s level of agitation.  My favorite book to learn how to respond to young children warmly but with limits is The Happiest Toddler on the Block by Dr. Harvey Karp.  His techniques support healthy attachment and children respond much more quickly than parents expect.  Everyone feels better, not just the kids!  Read Teaching Children Emotional Regulation: Can Happiest Toddler on the Block Help Kids AND Adults? for more on this amazing program and how it can help both of you.  Today.

Some of the OT treatments that help children also can help their parents with regulation issues and/or trauma histories.  Read Should the PARENTS of Kids With Sensory Issues Use Quickshifts?  and Stress Relief in the Time of Coronavirus: Enter Quickshifts about one easy treatment to develop a wider window of tolerance that works well for both children and adults.

UPDATE:  I was a speaker at the Healing Together conference in Orlando FL this month (Feb.2020). It was an amazing gathering for adults with dissociative disorders, their loved one/supporters and clinicians.  I highly recommend this conference to parents who are trauma survivors that struggle with dissociation.

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Secrets to Teaching Young Children to Share

 

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It is the rare toddler that eagerly gives up a desired toy or snack to share with another child.  Yup; your child isn’t any different from the great majority of kids out there.

You may even have witnessed the “grab-and-go” move, where they take a toy from another child and then quickly escape to a corner of the room.  I know it doesn’t feel great when the thief is your child, but it also doesn’t mean they are destined to be selfish or live a life of crime.  It is normal for young children to behave selfishly; they haven’t fully developed the cognitive abilities that provide them with awareness of another’s perspective, nor do they fully appreciate social norms.

So, what can you do to teach your child to share?

Well, here are a few things that don’t work:

  1. Shaming.  Telling your child that they are selfish and bad because they don’t want to share isn’t going to build empathy.  It may have the exact opposite effect.   And they may try to hide or deny their behavior from you.
  2. Bribing.  Paying off for good behavior has been scientifically proven to backfire.  Paying kids for good grades, paying employees to exercise or lose weight, etc.  It won’t create a more empathetic child, but it could create a scheming child who parlays their desire for something else into a little show for you.
  3. Begging.  Pleading with your child makes you look powerless and puts your child in an awkward-but-intoxicating position.  It won’t make you more credible when you deny them something or try to teach another civic lesson.
  4. Playing the “Your behavior makes Mommy sad” card.  Children desire love and will do almost anything for it, but making it appear that they have crushed your heart because they followed theirs?  This is a slippery slope, and shouldn’t be taken unless you think long and hard about what you are teaching.

So what ELSE could you do or say that might elicit sharing?

  • You can demonstrate sharing YOUR items, and be very clear about how you made the decision and how you feel.  Make sure that you admit that sometimes you want all of your snack for yourself, but then you remember how good it makes you feel when you share and see how happy the other person is.
  • You can also have another person say how they feel when you share with them.  Children really don’t always pick up on the subtle feelings of others, and they need to hear it out loud.
  • When your child does share, be crystal clear about how good it makes you feel when they do.  This is different from telling them how bad you feel when they don’t, and different from bribing them to share.
  • Read some age-appropriate books on sharing, and try to discuss how the characters felt in the story.  Some kids prefer to talk about characters and not about their own feelings.

Your child may still shrug and refuse to share, or they may want to try sharing, now that they know so much more about it!

How To Stop Your Toddler From Hitting You and Use The Fast Food Rule For Better Attunement With Your Child are two of my popular posts that also help you help your child manage their feelings without crushing their spirit!

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Does Your Toddler Resist Diaper Changes? End The Drama Today!

 

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does this look familiar? read on!

I regularly field questions about this problem from the parents of children I treat.   If your 8 to 24-month old is fussy during diaper changes and you know it isn’t from diaper rash, keep reading.  I have some information and ideas for you.

Parents of kids with sensory processing issues or developmental delays often assume that this is the source of their child’s diaper drama.  Parents who lack confidence or parents who spend a lot of time online with “Dr. Google” think that it could be sign of autism or of poor attachment.

Nope.

At least, not usually.

If your young child is suddenly giving you the business, even though they really need a diaper change, there are a few things to think about before you run to a developmental pediatrician (or any pediatrician):

  1. Your child may have been busy exploring, and they are unhappy that they were interrupted with a task they find boring.  Getting a fresh diaper isn’t much fun after those first few months of face-gazing and smiles.  Once a child can really play, they have better things to do.   Parents can be surprised that their gurgling infant that loved diaper changes is now resisting, or even fighting, to get off the changing table.
  2. If your child is one of the 15-20% of kids that Dr. Harvey Karp identifies as having a “spirited” temperament, then you are going to get a strong reaction to  almost any action they didn’t initiate.  Bedtimes, leaving to go to the park, leaving the park to go home, etc.  Spirited kids are going to give you oversized reactions in both directions; super happy, super sad, super angry.
  3. Kids with limited receptive language aren’t sure exactly what is going on when you pick them up.  Receptive language means understanding the words another person is using.  Your child doesn’t have to be delayed; they could simply not have enough language skills to understand what you are saying.
  4. Your child has decided to use diapering as their “line in the sand” to express their independence and test your limits.  Testing limits is normal, and I believe that nature intended this to start early.   By the time parents are experiencing limit testing with a teen, they have been practicing for a while.  Young children that feel that they are being controlled will test more and with more energy.  This doesn’t mean that their parents are actually more controlling.  Perception is reality, and if a child feels micro-managed, then they react whether or not they are indeed highly controlled.  This could happen when they spend a lot of time with babysitters instead of parents, or if they have had many recent changes in caregivers, new sibling, new home, etc.

What works to reduce diaper drama?

  • Use routines to improve language comprehension and manage expectations.  Kids that get a regular diaper check/change know what you are doing and where they are going.
  • Shorten your phrases and use the same words for the same events.  See above.
  • Try not to over-react to an overreaction.  Spirited kids don’t need more fuel for the fire, and neither do tired, sick, or hungry children.
  • Give your child more chances to control other situations in their life.  Manufacture the situations if you have to.  This means that they get to decide of the doll goes in the cradle or the car, or if the blue car goes down the ramp first, or if it is the red car that leads.  Dr. Karp’s “give it in fantasy” strategies  Give (Some of) Your Power Away To Your Defiant Toddler And Create Calmness and all of his positive “time-ins” are excellent ideas to build a child’s sense of fairness and autonomy.
  • Offer the 8-24 month old child something interesting to hold and look at during the diaper change.  It could be a new soft toy, but it might be better to give them a tiny collapsible colander to examine.  The novelty factor should buy you enough time to do the deed.  Remember to change it up regularly.  They need to learn to expect that this could be more fun than drama.
  • Older kids with the language skills to understand the negotiation could be asked “Do you want your diaper change NOW or in one minute?”  It doesn’t have to be 60 seconds later.  The idea is that you have given them a choice.  You have to stick to the agreement.  If they still balk after the minute is up, don’t use this again right away.  You will be teaching them that their protests work to avoid following your directions.  Oops.

The truth is that most children know that you are going to change their diaper regardless of their protests, and they can handle it if you help them a little bit.

 

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The JointSmart Child Series: Parents of Young Hypermobile Children Can Feel More Empowered and Confident Today!

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My first e-book, The Practical Guide to Toilet Training Your Child With Low Muscle Tone, was a wonderful experience to write and share.  The number of daily hits on one of my most popular blog posts  Hypermobility and Proprioception: Why Loose Joints Create Sensory Processing Problems for Children helped me figure out what my next e-book topic should be: hypermobility.

Hypermobility is a symptom that affects almost every aspect of a family’s life.  Unlike autism or cerebral palsy, online resources for parents are so limited and so generic that it was obvious that what was needed was solid practical information using everyday language.  Being empowered starts with knowledge and confidence.

The result?  My new e-book:  The JointSmart Child:  Living and Thriving With Hypermobility.  Volume One:  The Early Years.

What makes this book unique?

  • This manual explains how and why joint instability creates challenges in the simplest tasks of everyday life.
  • The sensory and behavioral consequences of hypermobility aren’t ignored; they are fully examined, and strategies to manage them are discussed in detail.
  • Busy parents can quickly spot the chapter that answers their questions by reading the short summaries at the beginning and end of each chapter.
  • This book emphasizes practical solutions over theories and medical jargon.
  • Parents learn how to create greater safety at home and in the community.
  • The appendices are forms that parents can use to improve communication with babysitters, family, teachers and doctors.

Who should read this book?

  1. Parents of hypermobile children ages 0-6, or children functioning in this developmental range.
  2. Therapists looking for new ideas for treatment or home programs.
  3. New therapists, or therapists who are entering pediatrics from another area of practice.
  4. Special educators, and educators that have hypermobile children mainstreamed into their classroom.

Looking for a preview?  Here is a sample from Chapter Three:  Positioning and Seating:

Some Basic Principles of Positioning:

Therapists learn the basics of positioning in school, and take advanced certification courses to be able to evaluate and prescribe equipment for their clients.  Parents can learn the basics too, and I feel strongly that it is essential to impart at least some of this information to every caregiver I meet.  A child’s therapists can help parents learn to use the equipment they have and help them select new equipment for their home.  The following principle are the easiest and most important principles of positioning for parents to learn:

  • The simplest rule I teach is “If it looks bad, it probably IS bad.”  Even without knowing the principles of positioning, or knowing what to do to fix things, parents can see that their child looks awkward or unsteady.  Once they recognize that their child isn’t in a stable or aligned position, they can try to improve the situation.  If they don’t know what to do, they can ask their child’s therapist for their professional advice.
  • The visual target is to achieve symmetrical alignment: a position in which a straight line is drawn through the center of a child”s face, down thorough the center of their chest and through the center of their pelvis.  Another visual target is to see that the natural curves of the spine (based on age) are supported.  Children will move out of alignment of course, but they should start form this symmetrical position.  Good movements occurs around this centered position.
  • Good positioning allows a child a balance of support and mobility.  Adults need to provide enough support, but also want to allow as much independent movement as possible.
  • The beginning of positioning is to achieve a stable pelvis.  Without a stable pelvis, stability at the feet, shoulders and head will be more difficult to achieve.  This can be accomplished by a combination of a waist or seatbelt, a cushion, and placing a child’s feet flat on a stable surface.
  • Anticipate the effects of activity and fatigue on positioning.  A child’s posture will shift as they move around in a chair, and this will make it harder for them to maintain a stable position.
  • Once a child is positioned as well as possible, monitor and adjust their position as needed.  Children aren’t crockpots; it isn’t possible to “set it and forget it.”  A child that is leaning too far to the side or too far forward, or whose hips have slid forward toward the front of the seat, isn’t necessarily tired.  They may simple need repositioning.
  • Equipment needs can change over time, even if a child is in a therapeutic seating system.  Children row physically and develop new skills that create new positioning needs.  If a child is unable to achieve a reasonable level of postural stability, they may need adjustments or new equipment.  This isn’t a failure; positioning hypermobile children is a fluid experience.

The JointSmart Child:  Living and Thriving With Hypermobility  Volume One:  The Early Years is now available as a read-only download on Amazon.com

It is available as a click-through and printable download  on Your Therapy Source!  

NEW:  Your Therapy Source is selling my new book along with The Practical Guide to Toilet Training Your Child With Low Muscle Tone as a bundle, saving you money and giving you a complete resource for the early years!

Already bought the book?  Please share your comments and suggestions for the next two books!  Volume Two is coming out in spring 2020, and will address the challenges of raising the school-aged child, and Volume Three focuses on the tween, teen, and young adult with hypermobility!

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Why Injuries to Hypermobile Joints Hurt Twice

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My new e-book, The JointSmart Child: Living and Thriving With Hypermobility, Volume I, is just about ready to launch.  One of the book’s major themes is that safety awareness is something that parents need to actively teach hypermobile young children.  Of course, physical and occupational therapists need to educate their parents first.  And they shouldn’t wait until things go off the rails to do so.

Hypermobile kids end up falling, tripping, and dropping things so often that most therapists have the “safety talk” with their parents on a regular basis.  What they don’t speak about as often are the long-term physical, emotional and social impacts of those injuries.

Yes, injuries have more than immediate physical effects on hypermobile kids.  Here is how this plays out:

  • The loss of mobility or function after an injury creates more dependency in a little person who is either striving for freedom or unsure that they want to be independent.  Needing to be carried, dressed or assisted with toileting when they were previously independent can alter a child’s motivation to the point where they may lose their enthusiasm for autonomy.  A child can decide that they would rather use the stroller than walk around the zoo or the mall.  They may avoid activities where they were injured, or fear going to therapy sessions.
  • A parent’s fear of a repeated injury can be perceived by a child as a message that the world is not a safe place, or that they aren’t capable in the world.  Instilling anxiety in a young child accidentally is all too easy.  A fearful look or a gasp may be all it takes.  Children look to adults to tell them about the world, and they don’t always parse our responses.  There is a name for fear of movement, whether it is fear of falling, pain or injury: kineseophobia.  This is rarely discussed, but the real-life impact can be significant.
  • Repeated injuries produce cumulative damage.  Even without a genetic connective tissue disorder such as Ehlers-Danlos syndrome, the ligaments, tendons, skin and joint capsules of hypermobile children don’t bounce back perfectly from repeated damage.  In fact, a cascade of problems can result.  Greaster instability in one area can create spasm and more force on another region.  Increased use of one limb can produce an overuse injury in the originally non-injured limb.  The choice to move less or restrict a child’s activity level can produce unwanted sedentary behavior such as a demand for more screen time or overeating.  Read more about how to prevent injuries here: Why Joint Protection Solutions for Hypermobility Aren’t Your Granny’s Joint Protection Strategies  
  • Being seen as “clumsy” or “careless” rather than hypermobile can affect a child’s self-image long after childhood is over.  Hypermobile kids grow up, but they don’t easily forget the names they were called or how they were described by others.  With or without a diagnosis, children are aware of how other people view them.  The exasperated look on a parent’s face when a child lands on the pavement isn’t ignored even if nothing is said.

Do you have a hyper mobile child under 6?  

I wrote an e-book for you!

The JointSmart Child:  Living and Thriving With Hypermobility  Volume One:  The Early Years is a totally unique book.  It is both a manual for finding the right equipment and using the right techniques as well as an educational book for parents who are trying to figure out why loose joints create so many difficulties in daily life.  It even has chapters on building relationships with babysitters, family members, teachers and medical professionals!

Visit Amazon to buy a read-only copy, or Your Therapy Source for a click-able and printable version.

 

In this new book, I provide parents with a roadmap for daily life that supports healthy movement and ADL independence while weaving in safety awareness.  Hypermobility has wide-reaching affects on young children, but it doesn’t have to be one major problem after another.  Practical strategies, combined with more understanding of the condition, regardless of the diagnosis, can make life joyful and full for every child!

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Targeted Toilet Training Strategies to Help The Child With A Receptive Language Delay

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After writing my first e-book, The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived! ,I continue to think of additional issues that can complicate (but not derail)  training.  One of these issues is a receptive language delay.  This is when a child’s ability to comprehend language is not age appropriate.  It may be accompanied by a delay in expressive language as well.  I don’t think it is a hard stop to training, but there are some strategies that improve the experience.  Not all of them are obvious.

When a child is unable to easily and quickly understand what you are saying during toilet training, you will need to do a few things differently:

  1. Expect to need established routines to support your verbal instruction.  This can include very regular trips to the potty rather than happening randomly.  Routines are essential for all children, but these kids really need them to shore up the language you are using.  Think about buying something in another language.  The routine or presenting the item, finding out the fee, offering payment and leaving with your item helps you get over the fact that you have forgotten most of your high school level French.  When they always sit on the potty right before a specific show, they know why and what you are saying more easily because they know the context.
  2. Use clear and consistent gestures and facial expressions as additional messaging while teaching and encouraging performance.  Gestures and facial expressions clarify your words and help kids respond quickly.  If they have too many accidents because they were confused, they could decide to stop cooperating.
  3. Monitor your language complexity, and consider simplifying it for ease of comprehension under stress.  As in the Fast Food Rule’s use of Toddler-ese, shorten phrases and emphasize important words.  This is not the time to lengthen your statements.  Repeat if necessary, but don’t elaborate.  Read Taming Toddler Tantrums Using Sympathetic Reframing for more details on TFFR.
  4. Assume that you will need to be more enthusiastic, more positive, and spend more time on training in general.  Your child is probably already someone with a short fuse.  Struggling to understand what people are saying makes that easy.  Now you are trying to teach a new skill, possibly one that they aren’t 100% excited to learn.  That doesn’t mean never teach it.  It means have a good plan, with lots of optimism and patience on your part.

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How To Get Your Kid To Share (Hint: The Fast Food Rule Will Be Used)

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Not a week goes by that a parent or nanny asks me how to get a young child, usually under 3, to share.  I get it; it is embarrassing when a toddler rips a toy away from another child, or has a death grip on a toy car while growling at their playdate friend.

Sharing isn’t something that comes naturally to most kids.  The rare child that hands over a toy when asked isn’t the average child.  You have to teach this behavior, and you have a couple of choices.  Only one is going to give you any peace:

  1. Threats:  Telling your child that if he doesn’t share that he will lose his valued toy.  This may work in the short run, but like spanking, you teach a child that violence or the threat of violence is the way to power.  We have too much of that already.
  2. Shame:  Telling a child that they are not nice people because they don’t want to share isn’t any better.  It doesn’t make it much kinder to say “You aren’t being nice right now”  because you still haven’t acknowledged the child’s feelings. Don’t we all carry around more shame than we can handle?  I know no one thinks they are shaming their child by saying this.  Stop now.  Make a better choice.
  3. Empathy followed by reality:  Using the Fast Food Rule, you tell the child what you think they are thinking “You don’t want to share; you want that car only for you” or an even simpler version “You say NO SHARE”.  When the child nods or in some physical or verbal way indicates that they understand you and agree that this is their opinion, you add sympathy to your voice and say something like “I am SO sorry, but it is XXX’s turn now.  You will get another turn later”.  Many times the child will hand over the car.  Sometimes you will have to take it, but they might not flip out.  Your empathy and their intelligence (if they are over 18 months old, they have had experience with sharing) will help them accept the reality.  Read Stop The Whining With The Fast Food Rule for more details on Dr. Harvey Karp’s excellent strategy.

Of course, if your child is exhausted, hungry, ill, or going through a change in routine, home, caregivers, new sibling, etc. all bets are off.  They are living on the edge, and thing could fall apart.  What do you do then?  You feed, give a nap, a hug, and remember that asking a stressed child to share isn’t going to go very well.  But you also use all Dr. Karp’s positive strategies, the ones he calls Time-Ins.  Things like Patience Stretching Stretch Your Toddler’s Patience, Starting Today! and Gossiping Let Your Toddler Hear You Gossiping (About Him!).

The altruism that gives birth to sharing should not be expected in children under 2.  We ask them to follow our sharing rules, and have to help them grow to an age and a place in which they can comprehend what sharing is really about.  You may have to wait until 4 or 5 to see your child really understand how the other child is feeling and why sharing with them works better than being selfish.  At a very young age, it is enough that they know we understand where they are coming from and we will help them follow this important social rule.

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Hypermobility Or Low Tone? Three Solutions to Mealtime Problems

 

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Many young hypermobile kids, with and without low muscle tone, struggle at mealtimes. Even after they have received skilled feeding therapy and can chew and swallow safely, they may continue to slide off their chair, spill food on the table (and on their body!) and refuse to use utensils.

It doesn’t have to be such a challenge.  In my new e-book coming out this year, I will address mealtime struggles.  But before the book is out there, I want to share three general solutions that can make self-feeding a lot easier for everyone:

  1. Teach self-feeding skills early and with optimism.  Even the youngest child can be taught that their hands must be near the bottle or cup, even when an adult is doing most of the work of holding it.  Allowing your infant to look around, play with your hair, etc. is telling them “This isn’t something you need to pay attention to.  This is my job, not yours.”  If your child has developmental delays for any reason, then I can assure you that they need to be more involved, not less.  It is going to take more effort for them to learn feeding skills, and they need your help to become interested and involved.  Right now.  That doesn’t mean you expect too much from them.  It means that you expect them to be part of the experience.  With a lot of positivity and good training from your OT or SLP, you will feel confident that you are asking for the right amount of involvement. Read Teach Spoon Grip By Making It Fun And Sharing a Laugh With Your Child and Teach Utensil Grasp and Control…Without the Food! for some good strategies to get things going.
  2. Use excellent positioning.  Your child needs a balance of stability and mobility.  Too much restriction means not enough movement for reach and grasp.  Too much movement would be like eating a steak while sitting in the back seat of your car doing 90 mph.  This may mean that they need a special booster seat, but more likely it means that they need to be sitting better in whatever seat they are in.  Read Kids With Low Muscle Tone Can Sit For Dinner: A Multi-Course Strategy for more ideas on this subject.  Chairs with footplates are a big fave with therapists, but only if a child has enough stability to sit in one without sliding about and can actively use their lower legs and hips for stabilization.  Again, ask your therapist so that you know that you have the right seat for the right stage of development.
  3. Use good tableware and utensils.  If your child is well trained and well supported, but their plates are sliding and their cups and utensils slide out of their hands, you still have a problem.  Picking out the best table tools is important and can be easier than you think.  Items that increase surface texture and fill the child’s grasping hand well are easiest to hold.  Read The Not-So-Secret Solution for Your Child With Motor And Sensory Issues: Dycem and OXO for Kids: Great Tableware For Older Kids With Sensory and Motor Issues for some good sources.  Getting branded tableware can be appealing to young children, and even picking out their favorite color will improve their cooperation.  Finally, using these tools for food preparation can be very motivating.  Children over 18 months of age can get excited about tearing lettuce leaves and pouring cereal from a small plastic pitcher.  Be creative and have fun!

 

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Does Your Child Hate Big Spaces? There is a Sensory-Based Explanation

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Space; the final frontier?

When you see it, it looks like Helen Keller crossed with a Roomba.  A child enters a space, even a familiar space, and runs the perimeter without stopping to play or examine things.  They may trace the room with their fingers, or repeat this process many times before they “land” and engage in some kind of purposeful activity.  If they get upset or challenged, they may resume this behavior.

One explanation for this behavior is that it is a solution to spatial processing difficulties.  When a typical child over the age of, let’s say 14 months, enters a room, they use their visual and auditory skills to tell them about the shape, height, and contents of the room.  As we mature, we use higher-order sensory input to inform our awareness and thinking.  We use sound in particular to tell us about the space to our sides and behind us that we cannot see.  Kids with ASD and SPD are stuck using immature types of information, and need to use them more often and more intensely to get the same knowledge.

How does this feel for them? Think of Notre Dame cathedral (before that awful fire).  The soaring ceilings and the long aisles create an other-worldly feeling you cannot escape.  Your brain knows you are not in your living room, or even in your own place of worship back home.  The medieval architects knew this too.  That was exactly the effect their were aiming for.  To set you back on your heels with the wonders of G-d.  How?  By making the spatial characteristics very unfamiliar and difficult to square with everyday experience.  To have you feel smaller and less in control in the presence of the almighty.

Now imagine that every space you inhabit gives you that feeling.  You enter a room and your eyes go everywhere.  You want to walk around to give yourself more information about where you are.  You don’t, but your nervous system is suggesting it.  You feel off balance and vulnerable.  Sound familiar?

What can you do?  Treating spatial processing issues isn’t easy.  Addressing limitations in vestibular and visual processing can really help, but I think that sound-based treatments are some of the easiest and most effective.  I use Quickshifts effectively to address spatial processing issues  Quickshifts: A Simple, Successful, and Easy to Use Treatment For Processing, Attention and Postural Activation.  Of course, it is best to address all the sensory processing issues any child has to get the best results.  You want to cement in the skills of better sensory processing by achieving good functioning in multiple situations.  But spatial processing problems have to be addressed to achieve a calmer and more organized state.  You want every child to feel safe and supported wherever they go!

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Effective sensory processing treatment helps kids feel safe in big spaces

Quickshifts: A Simple, Successful, and Easy to Use Treatment For Regulation, Attention, and Postural Activation

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Every child loves music, but not every music is therapy!

What if you could add a sensory-based treatment that targets specific sensory, motor, and behavioral goals, doesn’t require expensive equipment or a large therapy space, and you could see the effects within a very short time?

Since adding Quickshifts to my therapy sessions, I have been able to successfully address some of the more difficult behaviors and sensory processing issues I encounter.  Very young children are often afraid of being on therapy balls and swings, and they don’t always tolerate the Wilbarger or Astronaut protocols Why Is The Wilbarger Protocol So Hard To Get Right?.  But everyone can listen to music.  Enter Quickshifts.

I am primarily using them over speakers, since even older kids are struggling with wearing headphones.  I find that this isn’t preventing progress, and I periodically try to reintroduce headphones with children over 2.  They change so quickly that I never know when “NO” will turn into “maybe”.

Every Quickshift album uses brainwave entrainment.  The use of binaural beat technology (BBT) for entrainment of an alpha brainwave state has made a difference with the kids who display predominantly anxious or dysregulated states, but it is also very helpful to entrain better attention and postural activation.  Read more about the science behind BBT in Binaural Beats and Regulation; More Than Music Therapy.  It is great for parents too: Stress Relief in the Time of Coronavirus: Enter Quickshifts.

Quickshift albums are intended to rapidly bring the brain into this alpha state, with a focus on reducing anxiety and building affective modulation.  Yes; this form of therapeutic listening has the ability to decrease, not increase, anxiety.  But there are a wide range of albums.  Some emphasize postural activation, some work on sensory modulation and sensitivity, and some improve attentional focus or social interaction.  Why would music affect posture or anxiety?  Because these albums use specific rhythms and melodies, as well as binaural beat technology.  OTs know a lot about how sound affects brain function, and this isn’t about “liking” the music, although kids do.  It is about creating differences in the brain.

I am particularly fond of the regulation albums and the social interaction albums, as my clients inevitably struggle with these issues.  I can see a shift (not a pun:  the shift is real) about 5-7 minutes into the 14-17 minute albums.  This is helpful in a session.  If I only have 30-45 minutes, I cannot do 15 minutes of sensory input to achieve regulation.  I need more time for treatment goals.  This gives me precious minutes, and helps kids see that regulation is possible.

Why Modulated Music Wasn’t Working For Me

I stopped using Modulated music a long time ago.  I rarely use it with children under 5 now.  Not because I don’t think it was an effective treatment.  Because I couldn’t get any compliance at home, and I saw very little progress with use only in my therapy sessions.  There was often a learning phase, in which I had to adjust the amount of listening time to prevent overwhelming young or very challenged children.  Parents start to question my clinical skills and I risk losing their confidence.  Families were resistant; even the families that really wanted to use this music.

The way Modulated music needed to be scheduled and used (two daily 30-minute sessions, 2-3 hour wait before sleep times and between listening times) made it almost impossible to use with very young children at home, regardless of how willing parents seemed to be.  And very few parents were that willing.  Maybe they would be able to do insulin injections on a schedule, but not therapeutic music. Everyone is so over-scheduled and busy.   I hated begging, so I had to find something easier that also worked well.

Quickshifts:  More Flexible, More Easily Tolerated, More Effective in EI

Quickshifts have been much more flexible, but just as successful.  Maybe more!  They can be used often throughout the day, any time of the day.  I haven’t seen one small child react in a way that indicated that they were overwhelmed.  The ability to target specific types of sensory-based goals means I can deliver results the parents can see.  the emphasis on alpha brainwave states seems to deliver an extra layer of calmness.

Gearshifters are similar to Qucikshifts, but they do not have the targeted immediacy that I find so helpful.  When are Gearshifters better to use?  When I need a longer-lasting modulation effect and I don’t have concerns about spatial awareness or need to reduce agitation.  Some kids need a Quickshift album followed by a Gearshifter to have a few hours of really good sensory modulation time.

Use the best headphones!  Read  Doing Therapeutic Listening? Get These Affordable, Comfortable, Kid-Size Bluetooth Headphones From PURO!  to learn what equipment is going to make this work for you.

Parents are happy to be able to download the albums onto their phones and use them to improve transitions, sleep, attention and more. The use of technology to entrain an alpha brainwave state means that if the album isn’t a perfect fit, I don’t get an overwhelmed child; there is always some degree of improvement in regulation and arousal.  But when I have seen kids generate more postural activation, calm down and even laugh, or tune into their environments in ways they never have before Quickshifts, I wonder why I waited so long to get this treatment on board.  It isn’t just for sensory sensitivity or modulation problems; read more about how it can help kids with motor control issues here: Therapeutic Listening Can Enhance Motor Skills….Really!

Wondering if adults can use Quickshifts too?  Read  Should the PARENTS of Kids With Sensory Issues Use Quickshifts? for more about how this music can help everybody in the family.

If you are tempted to go out and buy these albums without the guidance of an OTR that is trained in sound therapy, please reconsider.  The reason that I have had such success with Quickshifts is not just because this treatment works.  It works because I use it as part of a whole sensory-based protocol, in which I can select and prescribe the right music to be used at the right time.  There really is a reason to have an OTR help you.  You will get better results, avoid problems, save time and money, and have someone trained in treatment guiding you.  Not Dr. Google.  I do phone consultations to help people decide on a sensory processing treatment plan that saves them time and money.  Visit my website tranquil babies to book a session!

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What To Say When Your Child Says “I Hate You!”

 

daiga-ellaby-699111-unsplashIt happens to almost every parent.  It could happen when your child is a fuming preschooler, or a haughty tween.  Doesn’t matter.  It still hurts.  A lot.  Even the sweetest child can hurl one of these statements out when they don’t get what they want or aren’t allowed to do something.

The biggest question isn’t “Why are they saying that?” but “How do I respond?”  There are a few choices I can think of that don’t involve nasty threats or violence.  Let’s drill down and see if there is one that rises above the crowd:

  • “But I love YOU!”  Hardly ever a winner.  Said with a warm smile or through gritted teeth, this rarely works well to alter a child’s attitude.  It seems that they work harder to explain why they are so annoyed/disgusted/irritated with you.
  • “Don’t you ever speak to me that way again!”  Well, you have drawn your line in the sand.  Let’s hope you have a consequence that you are willing to administer, because it is likely that you will be hearing this again.  Maybe soon.
  • “Wow, that hurts me”  OK, that sounds heartfelt and honest.  The problem is that at this moment, your child may be trying to hurt you.  You have just informed your child that success has been achieved.  In the long run they probably aren’t sociopaths, and they probably will regret hurting you.  But right now?  They aren’t in a place in which they care about your feelings as much as you’d like.

 

And the answer that might just work?

  • ” You are really, really mad at me right now”  Stating how they feel using a fraction of the energy and emotion that your child is spewing is, wait for it….The Happiest Toddler on the Block’s Fast Food Rule.  Yes, the same strategy you use when your two year-old’s cookie falls on the floor can help you with this situation as well.  Because making it clear to the upset person that you “get” them, even if you don’t agree with them, can dissipate some of the indignant venom fast.  You might have to repeat it again after you hear more words about what an idiot you are, or what a bad mommy you are.  Only after you see that they have dialed down some of the venom can you offer a solution, a trade, or a bit of commiseration.  Why?  Because jumping in too soon sends the message that what you’d truly like is to shut them up.  That will not be good.

Want more information on THTOTB strategies?  Read Help Your Child Develop Self-Regulation With Happiest Toddler On The Block and Stretch Your Toddler’s Patience, Starting Today!.