Category Archives: toy/equipment review

The Preschool Water Arcade Game You Need This Summer If Camp is Cancelled (and maybe even if it isn’t)

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I cannot BELIEVE how much fun this Step 2 Waterpark Arcade toy could be!  You hook it up to your outdoor garden hose and play.  As an occupational therapist, I want all of my older toddler and all my preschool clients to get one of these arcade games to work on visual-motor coordination and hand strength.

What kid isn’t right for this toy?

  • This isn’t a toy for a child that cannot resist the impulse to spray others, as the water flow could be pretty strong.   Almost every child is going to have some experimentation with controlling the hose.  That isn’t the same as intentionally nailing their baby brother in the face.
  • Nor is it a good choice for a child that is really unsteady on their feet.  It won’t be easy to handle a hose while sitting down, and too much failure is really hard on kids that are already stressed because of missing camp.
  • They have to have enough hand strength, even with two hands together, as shown, to squeeze the trigger while aiming.  Older kids can stand farther back from the toy and use one hand.
  • Kids with significant problems with strabismus may not be able to aim from a distance.  Strabismus will force them to use one eye to avoid “seeing double” at a distance.  Again, failure isn’t fun.  Weakening one eye isn’t a great idea either.  If this motivates a child to wear their special glasses or eye patch, on the other hand, it could help you get some compliance.

Can You Incorporate This Toy Into Fine Motor or Handwriting Practice?  SURE!!!!

  1. Parents can come up with a score sheet on the sidewalk with chalk, on a white board with a marker, or use a bucket with pebbles.  Every time a child hits the mark, they get a point.
  2. They can write a hash mark or erase the previous score and write the new one, which is great for preschoolers and kindergarteners to practice writing numbers over the summer.
  3. Of course, they have to write their names and their opponent’s name as well.
  4. Counting the pebbles without writing them could be great practice for younger kids.

Looking for more outdoor fun this summer?  Read Doing Preschool Camp at Home This Summer? This is the Water Table You Want!  Worried about rainy day fun?  Read Doing OT Telehealth? Start Cooking (And Baking)!

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Doing Preschool Camp at Home This Summer? This is the Water Table You Want!

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I just found this online after a parent asked me for recommendations for equipment.  She isn’t sending her two kids under 5 to camp this year, and needs some ideas to turn her backyard into a fun place to spend the summer.  This is the Little Tikes Magic Flower water table.

Why do I love this one?

Watch their video on Amazon and you will understand!  But before you do, here are my reasons, as an occupational therapist, for recommending this water table:

  • Multiple levels mean that children of different ages can both have fun.
  • Multiple ways to explore helps kids take turns without having to choose between “the fun thing” and the “barely OK things” on the water table.
  • The animal theme works for lots of kids.  Not everyone likes pirates.  Or even understands pirates.
  • It is big enough to have at least 2 kids playing at the same time, maybe 3.
  • They include 2 duckies (who doesn’t love duckies?), 2 frogs, 3 turtles, a fish, and three pouring choices.  I hate tables where you STILL have to go out and buy stuff to make it fun.  This table is “one-and-done”.
  •  All of my clients with low tone and hypermobility that can stand will be motivated to do so; there isn’t really any way to lean on this water table.  They can stabilize by holding an edge, but they cannot drape themselves over it.  They will be bending and reaching.  A lot.  That is a good thing.
  • Kids that use a wheelchair or need to sit while playing due to mobility issues will still be able to have fun with their friends and siblings that can stand and bend.  This water table is inclusive.

I really hate sand tables.  You would think that as an OTR, I would love them.

Nope.  Sand gets everywhere.  In clothes, in body folds, everywhere.  Kids get sand in their mouth and in their eyes.  It tracks into the house unless you shower your kid outside, and maybe it will be found inside even then.  Sand is a pain in the neck.

As long as you empty your water table and hit it regularly with some soap or a diluted bleach solution to keep it clean, it is much easier on everyone to have a water table rather than a sand table.  This one is going to be a lot of fun!

Need more ideas for fun this summer?  Read The Preschool Water Arcade Game You Need This Summer If Camp is Cancelled (and maybe even if it isn’t) and Doing OT Telehealth? Start Cooking (And Baking)!

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Child Struggling With Pencil Grasp During COVID-19? Flip Crayons Restore Skills

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All of my kindergarten clients and some of my preschool clients are using them.  None of them are backtracking into a fisted grasp with pre-writing or early handwriting.  Flip crayons from Learning Without Tears (formerly Handwriting Without Tears) are one of those simple grasp development strategies that keep on giving.

Why?  Their design does all the work for me.  Well, almost all the work.

Flip crayons have the same diameter of a standard school crayon, not a toddler crayon, or those ridiculous and useless egg/fingertip crayons Egg Crayons or Fingertip Crayons: When Good Marketing Slows Down Fine Motor Skill Development  .  They are shorter, so they do not allow a fisted grasp or even a palmer pronate grasp.  The crayon demands finer grasp, not the adult.

Selling an item to a child is important. They have to want to try these out.   I “sell” them as kindergarten crayons.  Every preschooler wants access to something they think is for older kids.  Their unique appearance is almost always appealing to kids.  I have met very few rigid kids, even with ASD, that are unwilling to give them a try.  Within a month of regular use, I see huge improvements in grasp without manhandling a child, begging them to “fix your fingers”,  or any of the other methods to address grasp issues.

COVID-19 is dragging us all down.  Why work harder than you have to?  I need children’s parents to see me as a problem solver, not someone asking them to work harder.  Flip crayons are an easy answer to a challenging problem.  I have another huge box of them sitting in my office to drop off as “gift baggies” at the end of the month!

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Need a Desk Chair for Your Hypermobile School-Age Child? Check out the Giantex Chair

 

71ASiKXBSJL._AC_SL1200_.jpgOne of my colleagues with a hypermobile third-grader told me this chair has been a great chair at school for her child.  It hits a lot of my targets for a chair recommendation, so here it is:  The Giantex chair.

Why do I like it so much?

  • It is a bit adaptable and sized for kids.  No chair fits every child, but the more you can adjust a chair, the more likely you are to provide good supportive seating.  This chair is a good balance of adaptability and affordability.  My readers know I am not a fan of therapy balls as seating for homework.  Here’s why: Should Hypermobile Kids Sit On Therapy Balls For Schoolwork?
  • It isn’t institutional.  Teachers, parents, and especially kids, get turned off by chairs that look like medical equipment.  This looks like a regular chair, but when adjusted correctly, it IS medical equipment, IMPO.
  • It’s affordable.  The child I described got it paid for by her school district to use in her classroom, but this chair is within the budget of some families.  They can have one at home for homework or meals.  Most kids aren’t too eager to use a Tripp Trapp chair after 6 or 7.  It’s untraditional looks bother them.  This chair isn’t going to turn them off as easily.
  • This chair looks like it would last through some growth.  I tell every parent that they only thing I can promise you is that your child will grow.  Even the kids with genetic disorders that affect growth will grow larger eventually.  This chair should fit kids from 8-12 years of age in most cases.  The really small ones or the really tall ones?  Maybe not, but the small ones will grow into it, and the tall kids probably fit into a smaller adult chair now or in the near future.

For more helpful posts on hypermobile kids, read Joint Protection And Hypermobility: Investing in Your Child’s FutureHow To Correctly Reposition Your Child’s Legs When They “W-Sit” and When Writing Hurts: The Hypermobile Hand.

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Want more information to help your child and make life easier?  My newest book has finally arrived!

The JointSmart Child:  Living and Thriving With Hypermobility  Volume Two: The School Years is now available as a read-only download on Amazon and a printable download on Your Therapy Source .  It is filled with the practical information that parents and therapists need to make kids’ lives easier, safer, and more independent.

There are extensive forms and checklists for school and home, and strategies that make immediate improvements in a child’s life.  Learn how to buy and fill a backpack that doesn’t damage a child’s joints, how blankets can create more pain and sleep problems,  and how to help a child write and keyboard with greater control.  Read more about it here: Parents and Therapists of Hypermobile School-Age Kids Finally Have a Practical Guidebook!

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Stress Relief in the Time of Coronavirus: Enter Quickshifts

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My clients know that I use therapeutic music called Quickshifts and Gearshifters in many pediatric therapy sessions.  They use binaural beat technology (Binaural Beats and Regulation: More Than Music Therapy ) to induce an alpha brainwave state.  This is the brain’s calm-alert state.  Due to the unprecedented stress we are all under, I am using them myself.  Every day, twice a day, minimum.  Here is why:

  1. I am no good to anyone if I am vibrating with anxiety.  There is only so much breath work can do for me.  I need brain work.
  2. The calm-alert brainwave state that Quickshifts and Gearshifters rapidly induces is effortless.  Turn it on, (they can be purchased and loaded onto your phone through the free Therapeutic Listening app) wear the headphones, and it works perfectly without me doing anything else.  I do have to stay off the screen stuff, but then, I should anyway.  Mostly I take a walk (alone) or crochet.
  3. I love music.  Most of us do.  I need music.  Most of us do.  I won’t listen to some droning boring sounds if I can listen to fun music instead.  Quickshifts have children’s music, classical music and gentle techno music that isn’t aggravatingly boring.
  4. The effects of altering brainwave states boost my immunity.  And there has never been a better time for it.
  5. I can bring it with me on a walk, so I get a double dose of healthy input.
  6. It isn’t tiring or distracting.
  7. I could use it more often than 2x/day.  There is no danger or downside, unlike modulated music.  Modulated music is a workout for your brain, and using it too close to bedtime can be a challenge.   Quickshifts and Gearshifters are designed for anxiety and even trauma recovery.  This pandemic is a trauma if I ever saw one.
  8. I can use it alone at home.  No one is getting massages, going to psychotherapy, or getting acupuncture.  There is no neurofeedback machine in my house.  I couldn’t go anywhere even if I wanted to.  Enter Quickshifts.

Quickshifts and Gearshifters are best used when selected for a client by a trained OTR.  Listening to the wrong album will not damage you or your child, but it is a waste of money and time.  Two things most of us are running out of right now.  

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Think Using Dot Markers Is Therapy for Kids in Preschool? Think Again!

 

S495361_2I had to look twice.  A private client showed me the picture her 4 year-old made in his school OT session (not the picture above!).  A picture decorated using a dot marker.  He can copy a vertical cross and a circle using a pencil.  I showed him how to draw a triangle in less than 4 minutes during that session.  He is very risk-averse and is probably intellectually gifted.   He has lots of sensory issues and mildly limited fine motor skills.

Why was he using a dot marker for anything?

I know his therapist isn’t very experienced, and I am sure the supplies budget isn’t huge.  But neither are good excuses for using tools that don’t raise the skill level of a child that is so hesitant to be challenged.  Those markers are great for toddlers under 2 or older children with motor skills under a 24-month level, especially kids with neurological or orthopedic issues that don’t allow them to easily grasp and control crayons.  Dot markers get children excited to make a mark on paper (an 11-month fine motor skill) and can be the first step to holding a tool to develop early pre-writing.

They aren’t good at all to develop any kind of mature pencil grasp due to their large diameter and large tip.  It would be like writing your name with a broom!

The ink tends to splatter with heavy quick contact with paper (fun to make a mess, but not therapeutic!), and doesn’t dry quickly enough.  Repeated contact bleeds colors together, and it is hard to keep within the borders of a design unless the target is very large.  I can assure you that the design above was done by an adult, an adult with some art training.

Dot markers aren’t building pre-writing skills for this child I treat.  There are so many options for activities that do build skills in kids at his ability level.  Their use can discourage a risk-averse child from working on pencil grasp.  Whatever the activity it was that they were doing, unless he was swinging on his belly on a platform swing or going down a ramp on a scooter (I don’t think he was doing anything nearly that intense) while using a dot marker, there were other, better choices to make.

Read Using A Vertical Easel in Preschool? WHERE You Draw on it Matters! and Deluxe Water Wow Pads Offer More Challenge And More Fun To Preschoolers and Kindergarteners for more good ideas on fun at home that builds pre-writing skills.

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Binaural Beats and Regulation: More Than Music Therapy

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When you have so much to choose from, how do you pick the right one?

Binaural beat technology isn’t new.  But it is powerful.  This post is designed to answer some questions about how it works, why it works, and how I use it effectively in the treatment of sensory processing issues.

For people who have read about or tried Quickshifts  Quickshifts: A Simple, Successful, and Easy to Use Treatment For Processing, Attention and Postural Activation, you may be wondering what all the fuss is about listening on headphones versus speakers, and why the music has that echo-y tone.

The use of binaural headphones or speakers placed close to the child allows the ears to hear the full range of sound with as little interference or absorption from the environment.  It is important that the left and right ear are hearing the sounds separately.  The echo-y sound?  What you are hearing is the BBT; binaural beat technology.  The slight alteration in sound frequency between what the brain hears from the left and right speakers forces the brain to synch up at a frequency that matches this level of difference.

BBT isn’t new.  BBT has been used and researched since the 70’s.  It is out there in many forms; you can even find recorded BBT music on YouTube.  There are enough studies done to prove that this technology has real effects on alertness, attention and mood.  It makes sense that therapists would like to use it to help kids with self-regulation issues.  BBT is helpful for learning and self-regulation, but only if you know what brainwave state you want, and why you want it.  And that is where skilled therapists can help.

But which one to use?

 I only use Quickshifts in my therapy sessions.

 

Why do I prefer Quickshifts to deliver BBT?

  • Quickshifts entrain an alpha brainwave state.  This state is associated with calm focus the ability to move to a more powerful focus or downshift into sleep, and, wait for it, interoception.  Yup, the biggest new word in occupational therapy is interoception, and there are some excellent studies done by neuropsych researchers that indicate that alpha brainwave states increase interoception.  Yeah!  Interoception is the ability to perceive internal states, and this includes basic physiological states such as fatigue, hunger, and the need to eliminate.  So many of our clients struggle with knowing what they feel.  Quickshifts can help.
  • Alpha brainwave states are theorized to act as a gating mechanism for anxiety, which means they help kids block anxiety.  Anxiety isn’t a great state for kids with ASD, SPD, or any of us.  Anxiety is a component of so many diagnoses, and it isn’t easy to do cognitive behavioral strategies like CBT or DBT with children under 10 or 11.  Quickshifts also work well for adults with anxiety as well! Should the PARENTS of Kids With Sensory Issues Use Quickshifts?
  • The music used in Quickshifts is very carefully designed to enhance specific functional states, and every occupational therapist is all about functional performance.  We don’t want just relaxation; we want engagement in life.  The way that Quickshifts uses music allows BBT to address specific behavioral performance abilities.  There are albums for attention, for movement, and for regulation.  They all use BBT.  For each particular album, one functional goal will predominate.  I don’t need to induce a meditative state in a child that is working on handwriting.  I need calm focus and better movement control.
  • The avoidance of pure tones means I don’t have to worry about seizure activity in kids with a seizure disorder.  The use of pure tones is a risk for seizures, so if a child has frequent seizures, I can be confident that I am not increasing them with this treatment.
  • The choice of instrumentation on Quickshifts albums is often more grounding than other BBT choices.  I want kids to feel grounded, not floating on a cloud.  That state makes it harder to pay attention, to speak, move, etc.  Being jolted into a high level of engagement without grounding isn’t great either.  Remember:  OT is all about functioning.  This happens at that “just right” point of arousal.
  • There is a progression of instrumentation and rhythm on many Quickshift albums that guides the brain into more environmental awareness and postural activation, but it is done gently.   Getting to an alpha state is a goal, but improving functional performance with less risk of overload is most important to me.  I have to give kids the ability to leave our session in a great state of mind.
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He picked out his perfect pumpkin!

Pillowfort at Target: Should You Ask Your Child’s OT Before You Click “Buy”?

 

There are so many families out there that need great equipment for their sensory kids.  Pillowfort materials are on sale at Target, one of my favorite big box stores.  The items are affordable and stylish.  But are they what you really need?  In order to get the products that serve your child’s needs, you may want to think beyond color and style.  The key to good equipment is having a big picture plan.  The wrong item for the wrong kid is worse than not hitting “send”.

Some good examples are their crash pad and their chair.  If you have a sensory-seeking kid, you know what abuse your couch and bed can take.  Kids tend to dive bomb them and little by little, destroy them.  Pillowfort will sell you a nice crash pad, and they use a smiling child lying prone on one of their pads in their display on Target.com.

You might want to look at the dimensions.  In my professional experience, most of my clients are looking for way more square footage to crash into.  And when they are dysregulated, which is often, they aren’t going to be able to land squarely on such a small pad.  Therapists use pad the size of a thick full mattress in their clinics for a reason.  We are all safety, all the time.  And we know what works to keep kids from cracking their heads on the floor.

Their rocking desk chair is another nice chair that will serve a small number of kids.  It looks pretty sturdy, but the big sensory seekers can wear out hinges really easily.  A chair that rocks is a chair that can become tippy with the right (or wrong) user.  Choose this chair only if you have a child that isn’t one of THOSE kids.

There are other choices for kids that seek movement, and they aren’t chairs.  They are sensory diets, created by therapists with years of experience in evaluating and treating your child.  Your OTR can give you simple activities you can do at home that target your child’s needs.  I just taught a family  how to do a vestibular input activity through telehealth.  We can help you!  Read Sensory Stimulation is not Sensory Treatment and Halloween With Sensory Sensitive Kids: The (Sensory) Tricks of the Holiday for more information on how Good OT treatment can help your child.

Looking for information to help your hypermobile child with Down syndrome, Prader-Willi syndrome, or Ehlers-Danlos syndrome?

I wrote 2 e-books for you!

The JointSmart Child:  Living and Thriving With Hypermobility Volume One:  The Early Years and Volume Two:  The School Years are now available on Amazon as  read-only downloads and at Your Therapy Source as printable and click-able downloads!

These books answer all the questions you want to ask about finding the right high chairs, clothes, toilet seats, bikes, desk chairs and even which crayons and pencils help your hypermobile child make faster progress.  It has checklists and forms to help you communicate with your babysitters, your child’s teachers, even forms to improve your appointments with doctors.

Chapters on communication give you practical ideas to improve your family’s understanding of hypermobility and guide you when speaking with doctors and therapists to provide you with real support that improves everyday life.  Get your book today, and start feeling more confident and empowered as a parent!

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Does Your Older Child Hate Writing? Try HWT’s Double-Lined Paper

 

This paper has been more useful to older kids (6+) that I see for handwriting help than any other paper on the market, and almost any other tool Problems With Handwriting? You Need The Best Eraser , Great Mechanical Pencils Can Improve Your Child’s Handwriting Skills .  Why?  Regular lined paper, and almost all worksheets, are usually jam-packed with lines.  Red lines, green lines, lines with airplanes and worms.  There are papers designed by occupational therapists that are even more complex than the mass-market choices.

All this is often visual noise to kids with sensory processing issues and ocular or visual-perceptual issues.  These problems are sometimes subtle and appear to be behavioral.  The kids who “hate to write”.  The kids who look away when you are demonstrating how to write a letter or spell a word.  The kids who cannot seem to remember where to start a letter, even after repeated practice.  These children often do much better with HWT’s double-lined paper.

Let’s drill down into the design of this unique paper:

  • Double-lined paper provides just two lines; the baseline and the midline.  Knowing where to start uppercase letters and tall lowercase letters is important, and this paper encourages practice and awareness while still giving some structure to writing.
  • There is a wide empty space between sets of lines.  This is intentional; children have room to place the tails of lowercase “y” and “j”, for example, without blocking the uppercase or tall lowercase letters of the next line of writing.  For many kids, not knowing what to do about crowding and spacing is a good reason to stop trying to write well, or sometimes even write at all.
  • This sturdy paper is pre-punched to be used in a 3-ring binder.  The quality of the paper is very high, which means that it doesn’t tear easily when a child erases a mistake.  Most schools provide the thinnest paper for teachers to use as handouts, creating the potential for a disaster when given to a child that struggles with grading their force on an eraser, or makes multiple errors in a word.
  • Brains get practice in sizing and proportion.  Once kids have a pattern of letter formation, it is easier to accomplish without the extra midline.  But so many kids need that “training wheel” effect much longer than scrolls recognize.  Many kids need a day or two of double-lined paper use to start understanding the way a letter “h” is twice as tall as a letter “a” and the same size but aligned differently than the letter “y”.  Of course, pointing it out is important, and so is working on other writing qualities such as letter and word spacing.
  • Kids write faster.  Because they are guided to proportion and start letters correctly, they don’t waste time thinking about it or erasing incorrect letters.  Again, this doesn’t mean their brain isn’t taking it all in.  If that were true, we would start every kid on single-lined paper in preschool.
  • There are three line sizes, so you don’t have to abandon the double-lines when your kid enter middle school.  I will admit that I wish the pre-k/K paper were thicker.  But it is still fairly sturdy.
  • You can alternate using this paper with single-lined paper to see when to “take the training wheels off” and stop using double-lined paper.  Kids should always have a chance to practice with standard paper, but when the choice is between fighting and crying, and quickly executing a homework assignment, it is no contest.

 

The best paper wins.

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Why Parents Used The Fisher-Price Rock and Play Sleeper: Desperation and Confusion

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As a Happiest Baby on the Block (HBOTB) educator, I was thrilled to hear about the product’s recall, and horrified at the number of deaths attributed to this device.  The media spent a lot of time pointing out that the company’s marketing included clear messaging that suggested that children could sleep in it, in defiance of the national pediatrician’s association’s recommendations that children sleep on a flat surface without padding or bedding until they are old enough to move to prevent suffocation.

Many of the stories online made it sound like the company must be out of their mind, or the parents must be idiots.  I don’t think that either thing is true.   I think I know why well-meaning parents listened to the printing on the box and not the hurried message/tri-fold handout from their child’s doctor:  they simply want some sleep.  They see how calm their child is in this device, and don’t know what else to do to get some peace and quiet.  Fisher-Price knew what I know; parents can be desperate and want a convenient solution to their struggles.  Their packaging mentioned both the warning and showed sleeping children in the device.

Babies are amazing, but babies don’t sleep through the night right away.  They often don'[t sleep through the night in the first 6 months.  That is a long time for parents to deal with their own chronic sleeplessness.  Many families are dual-earners, and many parents today are over 30.  Losing a night’s sleep at 23 and losing a night’s sleep at 39 are completely different.  One makes you sluggish.  The other makes you feel like you were hit by a truck.  Have that happen to you for a week, and you cannot handle screaming or exhaustion very well.  Really.  Do that for 6 months, and you might agree to almost anything anyone suggests to get a little more sleep.  When your child is so peaceful in that carrier or infant positioner, you may not want to risk waking them.  Do it anyway.  And learn how to get them back to sleep more easily.

One reason why I became a HBOTB educator was my sympathy for the parents I worked with as an occupational therapist.  These are kind people, intelligent people, but people who were not given great strategies by their pediatricians.  They were told what to do, but not HOW to do it.  Pediatricians aren’t given the time to walk parents through good techniques, even if they know them.  And a lot don’t know how to calm babies.  They know how to cure babies.  Dr. Karp’s techniques tell parents  how.

Since the arrival of the SNOO, things have become a bit simpler.  The need for education hasn’t ended, because unless you intend to spend the first 12 weeks at home each and every day, parents need to know how to calm their babies without a device.  Read Why You Still Need the 5S’s, Even If You Bought a SNOO   if you would like to know more about how HBOTB will save your sanity during the day.

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The Not-So-Secret Solution for Your Child With Motor And Sensory Issues: Dycem

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Many different ways to use Dycem!

In adult rehab, occupational therapists are regularly providing patients who have incoordination, muscle weakness or joint instability with both skill-building activities and adaptive equipment such as Dycem.  In pediatrics, you see a predominance of skills training.  Adaptive equipment shows up primarily for the most globally and pervasively disabled children.  I think that should change. Why?  Because frustration is an impediment to learning, and adaptive equipment can be like training wheels; you can take them off as skills develop.  When kids aren’t constantly frustrated, they are excited to try harder and feel supported by adults, not aggravated.

 

What Dycem Can Do For Your Child

Dycem isn’t a new product, but you hardly ever see it suggested to kids with mild to moderate motor incoordination, low tone, sensory processing disorders, hypermobility, and dyspraxia.  We let these kids struggle as their cereal bowl spills and their crayons roll away from them.  Dycem matting is a great tool for these kids.  It is grippy on both sides, but it is easy to clean.  Place a terrific bowl or plate on it OXO for Kids: Great Tableware For Older Kids With Sensory and Motor Issues, and it won’t tip over with gentle pressure, and not even if the surface has a slight incline.  It lasts a long time, and can be cut into any shape needed for a booster seat tray or under the base of a toy like a dollhouse or a toy garage.  Placing a piece of Dycem under your child while they are sitting on a tripp trap chair or a cube chair A Simple Strategy To Improve Your Child’s Posture In A Stokke Tripp Trapp or Special Tomato ChairThe Cube Chair: Your Special Needs Toddler’s New Favorite Seat! will help them keep their pelvis stable while they eat and play.  The bright color contrasts with most objects, supporting kids with visual deficits and poor visual perceptual skills.  It catches their eye and their attention.  As you can see, Dycem has a lot to offer children and parents.

How To Use Dycem To Build Motor Skills

Will it prevent all spills or falls?  No.  But it will decrease the constant failures that cause children to give up and request your help, or cause them to refuse to continue trying.  Children are creating their self-image earlier than you realize, so helping them see themselves as competent is essential.  Will it teach kids not to use their non-dominant hand to stabilize objects?  Not if an adult uses it correctly.  Introducing Dycem at the appropriate stage in motor development and varying when and where it is used is the key.  Children need lots of different types of situations in order to develop bilateral control, and as long as they are given a wide variety of opportunities, offering them adaptive equipment during key activities isn’t going to slow them down.  It will show them that we are supporting them on their journey.  When kids are new to an activity or a skill and need repeated successes to keep trying, Dycem can help them persevere.  When children are moving to the next level of skill and see that they are struggling more, Dycem can support them until they master this new level.

Should you buy the pre-cut mats or the roll of Dycem?  It depends on your needs.  Be aware that Dycem doesn’t stay tacky forever, so the cheaper strategy is the roll.

The Cheap Hack:  Silicone Mats

I will often recommend the use of silicone baking mats instead of dycem.  These inexpensive mats often do the job at a lower cost, and can be easily replaced if lost at daycare or school.  Dycem is a specialty item that can be purchased online but not in most stores.  Silicone mats aren’t as grippy, but they are easily washed and dried.  Some families are averse to anything that looks like adaptive equipment, so I may introduce these mats first to build a parent’s confidence in my recommendations.

Looking for more information on helping your child build self-care and safety awareness?

I wrote 2 e-books for you!

The Practical Guide to Toilet Training Your Child With Low Muscle Tone and The JointSmart Child: Living and Thriving With Hypermobility Volume One: The Early Years are unique books that both educate and empower you.

They are filled with understandable explanations for the challenges and all the confusion that comes up during ADL training.   When you aren’t provided with enough information on the motor, sensory and behavioral consequences of low tone and hypermobiilty, you can’t effectively help your child achieve the basic self-care and safety awareness skills that every child needs.  My books have checklists and forms that help you communicate with your babysitters, teachers, even your child’s doctors.

Both books are sold on Amazon.com  as read-only downloads, and on Your Therapy Source   as printable and click-able downloads.  Your Therapy Source also sells both books together as a discounted bundle, saving you money and giving you lots of information all at once!

 

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The Best Ride-On Toy For Younger (or Petite) Toddlers

 

61-g+QMVAYL._SL1000_.jpgAs an occupational therapist, I have always found it difficult to recommend a toddler ride-on toy for younger or smaller kids with low muscle tone and hypermobility.  Most of these toys have such a wide seat that children must propel themselves with their knees rotated out and pushing forward on their toes.  Exactly the pattern of movement we DON’T want to see.

And then I saw the Fly Bike.  This little fold-up bike has a seat that is about 9.5 inches high and has a very narrow seat.  This allows a child’s feet to be aligned with their hips, facilitating the development of hip and trunk control, not substituting bending forward and back to propel the toy.

The textured seat helps grip a child’s clothing for a little extra stability, and the small handlebars mean children aren’t draping their chest over the front of the toy; they are holding onto the handlebars with their hands.  Brilliant.  The rubber wheels are kind to indoor floors, but can handle pavement easily.

Are there children that don’t fit this toy?  Absolutely.  If your child is too tall for this toy, they shouldn’t use it.  If your child cannot maintain adequate sitting balance independently on this toy, they may need more support from another style of ride-on toy, perhaps with a larger seat and a backplate.

I finally have a great ride-on toy that I can recommend for smaller kids.  An early Xmas present to me and my little clients!

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Deluxe Water Wow Pads Offer More Challenge And More Fun To Preschoolers and Kindergarteners

 

91Wl4b-x3nL._SX425_.jpgMy clients and colleagues know how much I love the original Water Wow books.  They are reusable and mess-free fun for kids at home, at the doctor’s office, the restaurant and the plane ride.  These bigger books are going to be even more fun for preschool kids and kindergarteners!

Here are some great reasons why I love these books:

  • They have more pages, and more pages means they keep kids busy (and happy) longer.
  • They offer more detail and more challenge.  The graphics inspire critical thought (Is this a silly thing to find in the supermarket or not?) and the red lens that looks like a magnifying glass makes kids feel like Sherlock Holmes as they search for secret items.
  • There are mazes, hidden items and pages where kids can compare two almost-identical pictures and find the anomalies.  It is more than just wiping water on a picture.
  • Like the originals, the pages dry quickly and can be used over and over.  It seems like kids would get bored after the first run-through, but children can enjoy the “reveal” and the sensory play of water on a page for a long time after they have solved all the puzzles.  If you are at 30K feet and your kid is getting restless, this could buy you a bit of time without having to resort to screens that they will insist on for the rest of the (expensive) trip.  Genius.
  • Oh, and the pen is easy to grasp, and it develops a mature pencil grasp with repeated use.  Yeah!

I think these would be terrific holiday gifts.  If you are looking for more gift ideas, read Automoblox: For the Discriminating Preschool Gearhead and Melissa And Doug Tape Activity Book Is Reusable Fun for some other good toys that build skills while having fun!

DUPLO’s My First Number Train Set Is An Easy Way to Build Grasp in Toddlers!

 

 

91YccX0yt9L._SL1500_.jpgI really like this set from LEGO.  The DUPLO line is intended for children 18 months to 5 years old, but I think older kids will enjoy it as well when they combine pieces to make more complex designs.

The #1 reason I like this set is that the great majority of the pieces are easy to hold, easy to assemble, and hard to swallow.  I encourage families to remove the smaller pieces until their child is not prone to putting small things in their mouth.  But that still leaves so many pieces left for fun!

Young children struggle with asymmetrically-shaped pieces, so simple squares and rectangles are easier to manage.  The larger squares with numbers on them are especially easy to hold; they fit securely into the palm of a toddler and provide surface area for them to place their fingers securely on the sides of the blocks as they put two together.

In addition, the colors and the numbers are great for early learning.  Some of the families I work with get two sets and work on matching numbers and colors while they are working on grasp and coordination.

Oh, and the set is under $20 U.S.  Nothing like a value to make me smile!!!

BTW, the also make My First Letter Truck.  Same chunky pieces, you get a vehicle and a driver, but more of the chunky blocks that make this such a great building toy!!

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Boost Pincer Grasp With Tiny Containers

These days I am getting pretty…lazy.  My go-to items are designed so that children automatically  improve their grasp or their posture without my intervention.  I am  always searching for easy carryover strategies to share with parents too.  As with most things in life, easy is almost always better than complicated.

My recent fave piece of equipment to develop pincer grasp in toddlers and preschoolers is something you can pick up in your grocery store, but you are gonna use it quite differently from the manufacturer’s marketing plan….

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Remember these?

Enter the tiny party cup, AKA the disposable shot glass!  Yes, the one you used when you played “quarters” in school.  The very same.  These little cups work really well to teach toddlers to drink from an open cup, but they are also terrific containers to promote pincer grasp in young children.  Drop a few small snacks into these little cups and discourage them from dumping their snack onto the table instead of reaching inside with their fingers.

No matter how small your child’s fingers are, they will automatically attempt a tripod or pincer grasp to retrieve their treat.  You should’t have to say much of anything, but it never hurts to demonstrate how easy it is.  Make sure you eat your snack once you take it out of your cup.  After all, grownups deserve snacks too!

These little containers are much sturdier than paper cups.  This means that they can survive the grasp of a toddler who cannot grade their force well.  The cylindrical shape, with a slightly smaller base than top, naturally demands a refined grasp.  The cups have a bit of texture around the middle of the cup (at least mine do)  which gives some helpful tactile input to assist the non-dominant hand to maintain control during use.  They are top-shelf dishwasher safe and hand-washable, in case you feel strongly that disposables aren’t part of your scene.

Has your child mastered pincer grasp?  These little cups are fun to use in water and sand tables as well.  Mastery of pouring and scooping develops strong wrist and forearm control for utensil use and pre-writing with crayons.

For more ideas on developing grasp, take a look at Want Pincer Grasp Before Her First Birthday? Bet You’ll Be Surprised At What Moves (Hint) Build Hand Control! and Develop Pincer Grasp With Ziploc Bags.

 

The Cube Chair: Your Special Needs Toddler’s New Favorite Seat!

 

 

 

Finding a good chair for your special needs toddler isn’t easy.  Those cute table-and-chair sets from IKEA and Pottery Barn are made for older kids.  Sometimes much older, like the size of kids in kindergarten.  Even a larger child with motor or sensory issues will often fall right off those standard chairs!

Should you use a low bench or a chair?

I am a big fan of the Baby Bjorn footstool for bench sitting in therapy, but without a back, many toddlers don’t sit for very long without an adult to sit with them.  Independent sitting and playing is important to develop motor and cognitive skills.   The cute little toddler armchairs that you can get with their name embroidered on the backrest look great, but kids with sensory or motor issues end up in all sorts of awkward positions in them.  Those chairs aren’t a good choice for any hypermobile child or children with spasticity.

Enter the cube chair.  It has so many great features, I thought I would list them for you:

  • Made of plastic, it is relatively lightweight and easy to clean.  While not non-slip, there is a slight texture on the surface that helps objects grip a little.  Add some dycem or another non-slip surface, and you are all set.
  • Cube chairs can be a safe choice for “clumsy” kids. Kids fall. It happens to all of them.  The design makes it very stable, so it is harder to tip over. The rounded edges are safer than the sharp wooden corners on standard activity tables.
  • It isn’t very expensive.  Easily found on special needs sites, it is affordable and durable.
  • A cube chair is also a TABLE! That’s right; turn it over, and it is now a square table that doesn’t tip over easily when your toddler leans on it.
  • Get two:  now you have a chair and table set!  Or use them pushed together as a larger table or a stable surface for your child to cruise around to practice walking.  That texture will help them maintain their grip.  The chairs can stack for storage, but you really will be using them all the time.  You won’t be storing them.
  • It has two seat heights.  Look at the photos above:  when your child is younger, use the lower seat with a higher back and sides for support and safety.   When your child gets taller, use the other side for a slightly higher seat with less back support.
  • The cube chair is quite stable for kids that need to hold onto armrests to get in and out of a chair.  The truly therapeutic chairs, such as the Rifton line, are the ultimate in stability, but they are very expensive, very heavy, and made of solid wood.  They are often rejected by kids and families for their institutional look.  If you can use a cube chair, everyone will be happier.

Which kids don’t do well with these chairs?  

Children who use cube chairs have to be able to sit without assistance and actively use their hip and thigh muscles to stabilize their feet on the floor.  Kids with such significant trunk instability that they need a pelvic “seatbelt” and/or lateral supports won’t do well with this chair.  A cube chair isn’t going to give them enough postural support. If you aren’t sure if your child has these skills, ask your occupational or physical therapist.  They could save you money and time by giving you more specific seating recommendations for your child.

Your child may be too small or too large for a cube chair.  Kids who were born prematurely often remain smaller and shorter for the first years, and a child needs to be at least 28-30 inches tall (71-76 cm) to sit well in a cube chair without padding.

You may add a firm foam wedge to activate trunk muscles if they can use one and still maintain their posture in this chair, or use the Stokke-style chair (A Simple Strategy To Improve Your Child’s Posture In A Stokke Tripp Trapp or Special Tomato Chair ) or the Rifton chair until your child has developed enough control to take advantage of a cube chair.  If your child sits on the floor but uses a “W-sitting” pattern, learn about alternatives in Three Ways To Reduce W-Sitting (And Why It Matters) .

Looking for more information on positioning and play?  Check out Kids With Low Muscle Tone: The Hidden Problems With StrollersFor Kids With Sensory Issues and Low Tone, Add Resistance Instead of Hand-Over-Hand Assistance .

And of course…my NEW e-book!

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

It has an entire chapter on seating and positioning for ages 0-5, and so much more.  Chapters on how to carry and hold a child, how to build safety at home and in the community, and how to talk with your family, teachers, friends and even your doctor about your child’s needs!  Read more here: Parents of Young Hypermobile Children (and Their Therapists) Finally Get Their Empowerment Manual!

 

Worried about toilet training?  I wrote the e-book you are looking for!  

Read The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived! to learn why my book will help you more than a generalized special needs toileting book.  OK, I’ll tell you:  you learn why low tone makes thing harder, and why doing pre-training is like investing money for retirement.  It pays off in the long run!  Loaded with checklists and quick reference summaries made for busy parents, this book is filled with things you can start using immediately, even if your child isn’t close to independence.

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

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

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

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

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

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

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Automoblox: For the Discriminating Preschool Gearhead

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These cars and trucks are so well crafted and have such sophisticated styling that they even impress adults.  They certainly have made me a big fan!

Automoblox are small vehicles that your 3-6 year-old child assembles by themselves or with some initial help.  They have small pieces, so they are not for children that casually put objects in their mouths.  They are more challenging than Duplo LEGOs to assemble, but easier than those standard tiny LEGO pieces, and require far fewer parts to complete a vehicle.  So many younger kids want to be able to make a LEGO set by themselves, but get discouraged when they need so much help. They are in tears when their car falls apart because they didn’t have the ability to hold and manipulate the delicate LEGO vehicle with the necessary control.  Enter automoblox!

As a pediatric OT, I am often asked for advice on toys for holidays and birthdays.  These beautiful cars and trucks make terrific (if somewhat pricey) gifts for kids that may not be into arts-and-crafts but need to spend some time building visual-motor integration.  To assemble each vehicle, a child is required to use both hands in a skilled manner and use a refined grasp pattern.  Children don’t need significant strength for assembly, and most will learn the basic construction sequence quickly.

The pieces are mostly interchangeable between vehicles, meaning that although some wheels will only fit the car bases in their specific collection,  they do allow creative builders to experiment with new designs.  I LOVE it when kids create their own designs!

Parents who want to minimize the amount of plastic in their homes will be happy to know that the chassis are wood and some of the components are metal as well.  These cars roll very smoothly, and they stick together even after being crashed into walls, furniture and each other.  They can handle the rough play the average preschooler will dish out.

Take a look at automoblox this holiday season.  Your little gearhead (and probably dads and older siblings) will be thrilled to play with them!

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The Elf on the Shelf Could Get Your Child to Write a Letter to Santa!

 

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Write to Santa, but KEEP the note since the elf brings it to the North Pole…and then back to your home!

‘Tis the season, and Elf On The Shelf is back for more fun!  Some parents adore the concept and cannot wait to move that little elf around the house every night, and others mock him and his expanding merchandising.  Now that he is getting kids to write and draw, and parents will be able to save the heartfelt message as an ornament, I’m in with the Elf!  Not familiar with the Elf story?  Read Elf on the Shelf Controversy: Let’s Try Positive Gossiping to Santa.  Used as an encouragement and not a punishment or a threat, I am OK with this holiday tradition.

You use the paper and materials in the kit to write and bake-off a letter into an ornament that the elf “shows” to Santa on his nightly trip, and then he “returns” it to your tree.  The kit includes a storybook, materials to write, bake and hang your ornament.

As a pediatric occupational therapist, I wanted to share a few ideas that could make this more fun and a bit less stressful for children that struggle with handwriting, learning and attention issues:

  • The set includes 8 special sheets of paper that will get baked off in the oven to create an ornament, but I would encourage everyone to have their child refine their message and practice writing/drawing the note on regular paper before putting it on the special sheets.  Use these sheets as a template so that your child is aware that they can’t write more than a few lines at most.  There is no way to erase on the special sheets, and although some errors are charming, a child can be heartbroken if they think that they are sending a messy message.
  • I would encourage parents to consider copying the message so that kids have a sample to copy, rather than free writing.  Copying is an easier task in the developmental progression of handwriting, and reduces the stress for success on kids.  Nobody needs stress when making a special request to Old Saint Nick.
  • Younger kids, or kids with strong fears of failure or anxiety in general can draw or decorate a parent’s writing.  As long as they are involved, I don’t think it has to be all or nothing.  Many of my most avoidant clients get excited when I tell them that they just have to draw a sun (circle with rays) or some grass (short vertical lines that start at the top and descend to a baseline) to a picutre that I am drawing, and I  will take care of all the hard stuff.  Sometimes they even decide that they want to draw much more than they were planning to contribute.
  • Encourage your child to make the letters and designs a bit large, since they will shrink with the baking process.  Most young children cannot comprehend this step and will assume that the finished product will come out of the oven the same size that it was when it went in.  Tiny details may not be visible, tiny letters may be illegible.  Make a sample if possible for children that need proof of everything before they believe you.
  • If you know that your child may be impulsive or has such significant struggles with design, handwriting, or decision-making that you will need more than 8 sheets to create one final project, buy two kits.  The holidays are challenging enough without a fun activity ending without even one finished ornament.  If things go well and you don’t need the extra box, you have something that can be a wonderful gift for another family this season!

If you use this kit with your child this Christmas season, please write a comment and let my readers know how it worked out for you!

 

 

Make Wiping Your Child’s Nose Easier With Boogie Wipes

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It is cold and flu season here in the states, and I have already seen my share of snot-caked little faces.  Little children get more colds than older kids and adults, and they can turn into an agitated mess when you say “Honey, I need to wipe your nose”.  These wipes are going to make your job as chief booger-wiper a lot easier!

When I first saw Boogie Wipes, I will confess that I thought it was another expensive product to separate first-world parents from their money.  After all, I grew up on dry tissues and I survived.

I was wrong.  These really work.

At first, I thought that the use of moisture was the key to their success.  Not so.  Parents told me that using a regular baby wipe didn’t “do the deal” the way a Boogie Wipe took care of the snot problem and made kids calm down about nose-wiping.  I had to find out what really made this product better.

  1. Boogie Wipes have a few important ingredients that separate them from the standard baby wipes.  The first ingredient is water.  The second ingredient is sodium chloride; good old salt.  Saline is a combo of these two ingredients, and saline softens the gluey crud that is dried-on snot.  It also thins the still-wet snot so you can wipe it away without pressing so hard on tender skin.  Yeah!
  2. The next four ingredients are aloe leaf juice, chamomile flower extract, vitamin E and glycerin.  All gentle and (to most children) non-irritating skin conditioners.  I am a huge fan of Puffs Plus tissues, but these wipes are gentler than my fave tissues.  Children’s skin is so much more delicate than ours, and the ingredients in snot are so irritating.  That is even before it becomes a dried-on coating.  Boogie Wipes leave a thin coating of skin conditioners after you wipe your child’s face.  This coating acts as a slight skin barrier for the next drip of snot.  Brilliant!

The remaining ingredients are preservatives that prevent your open container of Boogie Wipes from becoming a source of germs instead of a source of relief.  I am sure that there are children who react to these preservatives, but I haven’t yet met any families that report problems over the years that this product has been available in NY.

Unless you know your child will react to these specific preservatives, I recommend trying the unscented version first (they come in fresh and lavender scents too) and using them before your child gets a cold.  It is kinder to find out that they are sensitive to any ingredients before their skin is already irritated by all that snot from an illness.  Kids whose skin is going to react will likely do so when well, but their skin can recover from any irritation more quickly when their immune system is not also fighting a bad cold.

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The Boogie folks do sell a saline spray as well as wipes, and I am all for using saline spray to loosen up internal nose crud.  The problem with sprays isn’t that they don’t work.  They do, and they work well.

The problem is that children are naturally avoidant of us sticking things up their noses, and they are really bad at controlling the “sniff” in order to efficiently suck the spray up into their sinuses.  I teach children how to blow their noses and how to handle sprays.  It is part of my job as an OTR.  Not the best part, but nevertheless, a part of teaching ADLs.  I haven’t had much success teaching children under 3 to use nose sprays.  They just get more frightened and upset.  If you have an older child or a child that seems less afraid of nose examinations at the pediatrician, then go ahead and give sprays a try.  It can really loosen up a clogged nose.

Good luck trying Boogie Wipes, or try the generic versions that I am starting to see on store shelves.  Imitation is the sincerest form of flattery, so manufacturers are telling us that they also know that these products really work!