NESCA is currently accepting Therapy and Executive Function Coaching clients from middle school-age through adulthood with Therapist/Executive Function Coach/Parent Coach Carly Loureiro, MSW, LCSW. Carly specializes in the ASD population and also sees individuals who are highly anxious, depressed, or suffer with low self-esteem. She also offers parent coaching and family sessions when needed. For more information or to schedule appointments, please complete our Intake Form.

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152

Sensory and Motor Strategies to Support Online Learning

By | NESCA Notes 2020

By: Julie Robinson, OT

Director of Clinical Services; Occupational Therapist, NESCA

For many families, this spring’s experience of remote learning and receiving integrated services was challenging, to say the least. As parents begin to think about their children returning to school this fall questions and concerns arise, not only about regression, but also how they will keep their children engaged in online learning.

For children with sensory processing difficulties and/or motor delays, there may be additional challenges in participating in Zoom classes and remote group learning. Some may have difficulty sustaining their attention, settling their body down to sit in front of a screen, managing the visual challenges of a screen, engaging socially or transitioning from a desired task to an academic one. Below are some suggested strategies, from an OT perspective, that may help your child participate in academics with less stress.

Regulation Strategies

The term “regulation” refers to someone’s ability to match their level of alertness (or arousal) to the environment and an activity. Throughout the day, our brain and our bodies are working to either increase or decrease our arousal levels for us to feel regulated and feel “just right” for the situation.

Sometimes children may have trouble with regulating themselves, causing them to experience dysregulation. Dysregulation can look very different depending on the child and can present as low levels of arousal or high level of arousal. This state may make it challenging for the child to be engaged and participate in certain activities, such as online learning. Sensory strategies are ways to help a child either increase arousal or lower arousal to match the needs of the task of online learning.

If a child is experiencing a low level of arousal, or their engine is running low, they should use a sensory strategy to help feel more alert. These include activities that have fast movement and increase heart rate. Taking movement breaks throughout the day is key! This could mean:

  • Jumping Jacks
  • Frog jumps or jumping on a trampoline
  • Playing at an outdoor playground
  • Creating an obstacle course
  • Doing something as simple as taking a walk around the house
  • Using a sit and spin or bouncing on a therapy ball
  • Hanging from a chin-up bar

If a child is experiencing a high level of arousal and their engine is running high, a sensory strategy to help them feel calm is beneficial. Calming strategies tend to be slower and more rhythmic. Ways to help slow down a child’s engine include:

  • “Heavy work,” such as wall push-ups, carrying books, laundry or groceries, wheelbarrow walk or crab walk can do the trick.
  • Yoga poses. Cosmic Kids Yoga on YouTube has some good videos with stories to encourage young children.
  • Creating a “sensory space” that is quiet and free from distractions. This could be a beanbag chair in the corner, a pop-up tent or a space behind a piece of furniture.
  • Using a weighted/heavy blanket or doing work on the ground with pillows underneath while spending time online may help your child to settle his or her body down. Explore the use of a therapy ball, T-stool, Move and Sit cushion or bike pedals that go under a chair to help kids who have difficulty sitting still.
  • Tactile play can be very calming for some children. Make a bucket of beans and hide small objects in it. Working with Playdough, shaving cream or water play can also help.
  • Encourage deep breathing to promote relaxation. Blow soap bubbles with a straw, pretend to blow out candles or blow a pinwheel.
  • An icy drink or popsicle can prove calming for many children. Or allow them to chew gum while learning to facilitate attention.

Strategies for Transition into Online Learning

As the new school year approaches, the change of routine into online learning may be a challenge for some kids. Here are some strategies to help your child adjust:

  • Create a clear schedule for your child that they can follow throughout the day (and make sure to schedule in plenty of breaks!). It may be helpful to use visuals or pictures, similar to a preschool schedule to help structure the time.
  • Make time for movement breaks around the house or outside. It may help to engage in a movement activity for 10-15 minutes before settling into an online class.
  • Use timers when needed (apps that have a visual timer, such as “Time Timer,” can be beneficial).
  • Create a designated space for the child to do their learning and make it their own.
  • Factor in a reward for good participation at the end of a virtual learning session, particularly for a child who seems resistant to remote learning.
  • Practice some brief online learning opportunities before school begins and slowly increase the time incrementally. Conduct Zoom calls with grandparents or other relatives where they read to the child to help maintain their attention. Search on YouTube together for some craft activities to follow along with. Khan Academy and Outschool have all kinds of online lessons for kids of all ages.

 Preventing Visual Fatigue in Online Learning

Along with the many challenges that come with online learning, the constant staring at electronics can cause strain or fatigue on the eyes. Eye strain can present as headaches, blurry vision, tired eyes and neck aches. In this world of virtual learning, it is more important than ever to help kids with strategies to prevent digital eye strain. Here are some strategies:

  • Turn down the screen brightness and turn up the contrast on screen settings.
  • Every 15-20 minutes, make sure to take a break from looking at the screen; set timers if needed. Sometimes placing your hands over your eyes and staring into them with open eyes can help. No matter what the day’s schedule is, always encourage a break from looking at the screen when needed.
  • Zoom in when text is too small.
  • Set limits for recreational use of electronics and avoid electronics before bed.
  • Sit in an ergonomically proper position when using the computer. This means keeping feet flat on the floor, lower back supported and shoulders related, and arms at a right angle.
  • Position the screen to avoid glare and use natural lighting as much as possible.
  • For a child who may have difficulty looking back and forth from a screen to paper, it may help to place the paper on a contrasting background of red or yellow.

 

About the Author

Julie Robinson is an occupational therapist with over 25 years of experience as a clinician. The work Julie does is integral to human development, wellness and a solid family unit. She particularly enjoys supporting families through the process of adoption and in working with children who are victims of trauma. Julie has extensive experience working with children diagnosed with an Autism Spectrum Disorder (ASD), or who have learning or emotional disabilities. She provides services that address Sensory Processing Disorder (SPD) and self-regulation challenges, as well as development of motor and executive functioning skills.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

149

Sitting Down to Work – Tips for Proper Set-up and Posture

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L

Occupational Therapist; Real-life Skills Program Manager and Coach

When working from home, it’s easy to ignore the important things that most people know about maintaining proper posture. The draw of a bed covered in pillows or a cozy nook on the couch can outweigh the rational knowledge that sitting with good posture will help us to stay focused, decrease back or joint pain, and help build a strong core. When it comes to children, they are often unaware of the ways that posture can affect their bodies and their work. They need cues, reminders and examples of the best way to sit to stay focused and be productive. In our last OT Tuesday blog, we discussed the importance of a child’s physical foundation, the core. When it comes to learning, a strong core helps with postural stability. As the start of a new school year draws near, let’s review some important things to consider about the environment and physical set-up for learning and the best positions for our students’ bodies.

Creating a space for learning helps to differentiate between school and home activities that, for many students, are currently happening in the same building. Here are some tips for setting up this space:

  • Find appropriately sized furniture. Children should have their feet on the ground when sitting at their desk! Tables should be at an appropriate height. Tables that are too tall tend to prompt children to hunch their shoulders or sit on their feet, while tables that are too small cause children to slouch and lean their heads on their hands.
  • Help them organize. Classrooms are built to help students grow their executive function skills, as teachers constantly help set up organizational systems and use tricks to keep students on track. Your child may benefit from color coded folders for each subject, a hard copy of their daily schedule (with pictures for younger kids!) or a visual timer.

There are also a few important things to remember to help with proper seated posture.

  • Use visual reminders. Your child may benefit from a picture of someone using proper seated position posted near their workspace. While they may still need a reminder every so often, having an image gives children a model to mimic.
  • The Rule of 90 Degrees. When sitting at a table, children’s hips, knees and ankles should all be positioned at 90 degrees. This helps to create a solid foundation. When children have a strong foundation and postural stability, they are set up to freely and accurately use their fine motor skills. Being grounded allows for easier writing, typing, cutting and manipulation of all the tools necessary for learning. Ideally, children’s elbows will also create a 90 degree angle.
  • Consider a slant board. Placing a computer or a paper on a slanted board can help students realize that they need to sit up straight, promote proper wrist placement and angle, and draw their eye gaze up from the desk. Writing on a vertical or slanted surface in general can help with the development of handwriting skills.
  • Stabilize that paper. Reminding students to use their non-dominant hand to hold their paper helps with precision and accuracy.
  • Allow them to switch it up! Some tasks really require a child to be sitting up straight, grounded and engaged. For example, a student who is hand-writing a final copy of their paragraph or using scissors for an art class will want to be cognizant of their bodies and how they are seated. In contrast, some activities provide opportunities to move around and change positions. If a student is reading a book for English Language Arts, they may want to lie on their belly or sit in a beanbag chair.
  • Take breaks. No matter how perfect a child’s seated posture is, they will benefit from movement and stretching breaks. Little bodies are built to move, bounce and wiggle!

Prioritizing posture as a child helps to build good habits, evenly distribute stress on the body’s muscle ligaments and joints, and create a strong, grounded foundation.

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

149

Core Strength and Stability: The Physical Foundation

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L

Occupational Therapist; Real-life Skills Program Manager and Coach

As our country heads into a period of unique learning, whether through a remote learning experience, a hybrid model or an in-person option with heightened rules and regulations, I find myself focusing on foundation. Foundation, simply defined, means, “the basis upon which something stands or is supported.” Currently, we are looking at a huge shift in how programs will run, how teachers will teach and how schools will support our children, but these principles are rooted in strong foundations. Our educators have knowledge, proven methods and an evidence base that allows for creativity, flexibility and evolution.

With regard to our students, foundational skills are the basics that help them feel secure and grounded enough to tackle the more individualized and creative aspects of learning. It is, in part, due to these foundational skills that many of our surprisingly resilient children have handled the COVID-19 pandemic with more flexibility and grace than the adults in their lives.

Today, let’s highlight the physical foundation that supports a child throughout their day, the core. Anatomically, the core refers to the transverse abdominis, internal and external oblique muscles, rectus abdominis, and the multifidus and erector spinae. This group of muscles holds a child upright when they are sitting at their seat, standing in line and running around on the playground. It is one of the foundational elements that promotes healthy motor development. Having a strong and active core makes it easier for a child to use their fine motor muscles with intent, stay alert for the duration of a class or a Zoom session, and develop healthy postural habits. Occupational therapists are trained to determine whether these activities are being affected by a weak core and if there is a need for intervention. Teachers and parents who spend substantial time with our children may want to be aware of and look out for the clues and signals of core instability, which include:

  • Compensatory strategies for stability – These are the subconscious ways that children compensate for core weakness. Essentially, they are bad habits that initially help to keep kids from getting too fatigued to participate in activities, but can have negative long-term effects. Some common examples include “W-sitting” and holding a breath during activities that require strength.
  • Leaning on anything and everything – Some children sit and lean their head on their hands or the desk when they write, lean against adults when standing up or sitting on a couch, and lean on furniture or tables when they are standing at home. These same students often slouch down in their seats and hunch their shoulders forward when they stand. This could signify a weak core.
  • Difficulty with balance – The inability to stay balanced and upright may be due to core instability. Many children are still developing the ability to run, jump, walk across a balance beam and stand on one foot, but if they seem to be falling over or losing control of their body more frequently than their peers, a weak core may be the culprit. These balance issues may also be apparent when a child is doing daily activities, such as getting dressed, putting on shoes or getting in and out of a car.
  • Difficulty with fine motor tasks – Sometimes children have a strong core and still have weak fine motor skills; however, often a weak core is exacerbating fine motor deficits. There is a little phrase that goes, “proximal stability for distal mobility” that is used by therapists, yogis and personal trainers alike. This means that it is important to have strength and stability at the core to easily move and control the muscles in our arms and legs.

Notably, helping a child to build their core is not always as simple as doing a few targeted exercises. While pure muscle strength may be the root cause of instability, it is not the only possibility. Other causes include poor alignment of the ribcage and pelvis, the need for some neuromuscular reeducation to help children engage the right muscles, and breathing habits that interfere with proper muscle use. If you feel like core weakness may be interfering with your child’s success, it may be worth seeking an occupational therapy assessment or speaking to your school’s occupational therapist about how to help them feel secure, sturdy and grounded. We can all benefit from a strong foundation.

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.