Tag Archives: sensory processing

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 should know 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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Should the PARENTS of Kids With Sensory Issues Use Quickshifts?

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My clients and my blog readers know that I started using a therapeutic sound treatment called Quckshifts earlier this year Quickshifts: A Simple, Successful, and Easy to Use Treatment For Regulation, Attention, and Postural Activation.  I haven’t lost my enthusiasm for this treatment.  It has made easy sessions more effective, and difficult sessions workable.  Kids that are struggling get a boost, and kids that needed a lot of preparatory sensory activity to regulate and engage rapidly find their footing.

Could this be useful for parents too?

There is no age limit on the use of Quickshifts, and the creators at Vital Links write and speak about treating adults using this program in their training materials.  But thus far I haven’t heard them talk about the use of Quickshifts with the parents of their clients.  I wonder why.

If you have a child with sensory issues, even one who attends mainstreamed programs and is doing fairly well in social activities, your days have a certain level of stress in them.  Sensory diets work, but they also take work to use and monitor.  Children aren’t crockpots, so you are actively administering or at least setting up the activities the comprise a sensory diet.  Kids reach bumps in the road, and kids with sensory issues can have bigger meltdowns over smaller bumps.  Parents have to help them manage things that other kids shrug off.  And parents always are thinking ahead, wondering what effect a new summer camp or new school with have on their child.  Even when things are going well, parents can feel some stress about all of these things.

It is well known that if you are a therapist treating children with sensory processing issues, at least one parent could say to you “Wow; I used to have the same problems, and everyone told me I was just being difficult/stubborn/picky, etc.”  Treatment options picked up in the early 90s, so we do hear this less and less.  But not in every community  or school system.  And if a parent’s parents refused to “believe” in sensory treatment, then these kids got nothing.  Or perhaps they were sent to a psychologist.  When I describe their child’s experiences using sensory processing terms, some parents recognize that their responses are very similar.  They have been told, or they have assumed, that they are reacting psychologically to events or stimuli.  They now are thinking differently about themselves as well as their children.

Finally, in this era of #MeToo, there is growing awareness that many of the parents of the children we work with bring their own trauma with them into parenting  Are You a Trauma Survivor AND the Parent of a Special Needs Child?.  I just did a presentation in FL (Feb2020) on using sensory processing treatment to help adults with traumatic dissociation.  The dysregulation that accompanies trauma doesn’t disappear after delivering a child.  At times, having a child can bring past traumas up to the surface and create problems that seems to have been handled or forgotten.  These parents need our support and assistance.

Which brings us to the question:  Should the parents of kids with sensory processing issues, especially the parents that have problems with self-regulation, use Quickshifts as well?

My strong opinion is that since there isn’t a downside, they should give the Regulation albums a try, and see how they navigate a typical day after listening.  The changes in adults are more subtle because their lives are more complex.  Parents need to know what changes to look for: usually the ability to remain calm with transitions, to focus on a task or to think a process through more easily.

Parents with more anxious tendencies might use Gentle Focus successfully, and parents that need to up-regulate would love Synching Up or Rockin’ Surf.  The decision to use Quickshifts and how to select albums really is easier when you consult an OT.  Wasting money and time buying and using the wrong album is unnecessary!  I love working with adults that have regulation issues or sensory sensitivities.  The relief in their faces tells me that they are getting the help they need to be their best.

 

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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 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 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

And also 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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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 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 address some of the more difficult behaviors and sensory processing issues I encounter in EI.  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.  Read more about 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.

Why Modulated Music Wasn’t Working For Me

I stopped using Modulated music a long time ago.  Not because I didn’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.  Using them only in treatment sessions seemed to make little meaningful difference in my little customers.  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.  I hated begging, so I had to find something easier that 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.

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.

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 is 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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Sensory Stimulation is not Sensory Treatment

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I thought that I might never hear it again, but there it was.  Another parent telling me that a member of her child’s treatment team had placed her hands in a rice-and-bean bin.  “Why?” I asked.  “She said it was sensory.” was the response.  This particular child has no aversions to touch, and no sensory-seeking behaviors either.  Her aversion to movement out of a vertical head position keeps her in my sessions, and her postural instability and hypermobility will keep her in PT for a while. But unless she is swishing around in that box while on a balance board or while she is sitting on a therapy ball (BTW…not) it isn’t therapy.   I struggle to see the therapeutic benefit for her specifically.  It is sensory play, but it isn’t therapy.

It seems that OTs got so good at being known for sensory-based interventions and fun activities, that it appears that engaging in sensory play is therapy.

Let me be clear:  if your child is demonstrating sensory processing issues, random sensory input will not help them any more than random vitamin use will address scurvy or random exercises will tone your belly.

Sensory processing treatment is based on assessment.  Real assessment.  A treatment plan is developed using an understanding of the way individual sensory modalities and combinations of modalities are neurologically and psychologically interpreted (remember, mind-body connection!)  It is delivered in a specific intensity, duration, location and/or position, and in a particular sequence.  I know it LOOKS like I am playing, and the child is playing, but this is therapy.  In the same way that a PT creates an exercise program or a psychotherapist guides a patient through recalling and processing trauma, I have a plan, know my tools, and I adjust activities on the fly to help a child build skills.

I never want to make other professionals look bad in front of a parent.  That’s not right.  I ended up making a suggestion that the therapist could use that would be actually therapeutic.  Some day I hope to finish my next e-book, the one on hypermobility, and hope that the information will expand the understanding of what OT is and is not.  It is absolutely not playing in sensory bins….

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Kids With Low Muscle Tone: The Hidden Problems With Strollers

jeremy-paige-146338-unsplashWhether you live in the city or the ‘burbs, you almost certainly use a stroller for your infant or toddler.  Even parents who use slings or carriers for “baby wearing”  find themselves needing a stroller at some point.  Why are strollers a problem for children with low muscle tone?  The answer is simple:  sling seats and ineffective safety straps.

The Challenges of a Sling Seat:

Strollers, especially the umbrella strollers that fold up into slim spaces, have a sling seat, not a flat and firm seat.  Like a hammock or a folding lawn chair, these seats won’t give a child a solid surface that activates their trunk.  When a child sits in a sling seat, they have to work harder to hold their body in a centered and stable position.

Why is that important when you are transporting your child in a stroller?

Because without a stable and active core, your child will have to work harder to speak and look around.  A child with low muscle tone or hypermobility that is in a sling seat may be inclined to be less active and involved, even fatigued from all that work to stay stable.  It could appear that they are shy or uninterested, but they might be at a physical disadvantage instead.  A collapsed posture also encourages compensations like tilting the head and rounding the back.  Will it cause torticollis or scoliosis?  Probably not, but it is certainly going to encourage a child to fall into those asymmetrical patterns.  Kids with low tone don’t need any help to learn bad habits of movement and positioning.

Safety strap location and use in many strollers is less than optimal.  

There are usually hip and chest straps on a stroller.  Some parents opt to keep them loose or not use them at all, thinking that kids are being unnecessarily restrained.  I think this is a mistake for kids with low tone.

Good support at the hips is essential when a child with low tone sits in a sling seat.  It is their best chance to be given some support.  Chest straps are often not adjusted as the child grows.  I see two patterns:  Straps too low for an older child, and straps too high for a younger one.  The latter issue usually occurs when parents never adjusted the straps after purchase.  They left them in the position they were in from the factory.  Make sure that the straps are tight enough to give support but not so tight that a child is unable to move at all.  A child that is used to sliding forward may complain about having their hips secured so that they can’t slouch, but they will get used to it.

You may have to reposition a child with low tone from time to time as you go about your errands or adventures.  They often don’t have the strength or body awareness to do so themselves.  They could be in a very awkward position and not complain at all.  Check their sitting position as you stroll along.  Good positioning isn’t “one and done” with these kids, but doing it right will benefit them while they are in the stroller, and also when they get out!

Looking for more information that could make things easier for your child and for yourself?

I wrote an e-book for you!

The JointSmart Child: Living and Thriving With Hypermobility Volume One:  The Early Years is finally available!

Filled with more information on seating and positioning, how to select the right high chair, and how to help your child learn to get dressed and use a spoon or fork, it is the manual that parents have been looking for!  There are even chapters on how to improve connection and communication with family, your child’s siblings, teachers, and doctors.  Parents who know what to do and what questions to ask feel confident and empowered.

This unique book is available as a printable and click-able download at Your Therapy Source and as a read-only digital download on Amazon.com

Is your back killing you every time you lift your child out of their stroller or crib?

Parents of children with special needs often neglect their own bodies in service of their children.  This is a shame because there are things you can do to protect your body and make your life easier while caring for your child.  Read How An Aging-In-Place Specialist Can Help You Design an Accessible Home for Your Child and Universal Design For Parents of Special Needs Kids: It’s Important for You Too!.

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