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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julie robinson

153

Buyer’s Guide 101: How to Shop for a Pediatric Occupational Therapist

By | NESCA Notes 2021

By: Julie Robinson, OT
Director of Clinical Services; Occupational Therapist, NESCA

As a parent of a child who has just been referred for Occupational Therapy (OT) services, the prospect of what to do next and where to go can be quite confusing. With so many providers in the area, it can be difficult to know who would be the right fit for your family. Typically, when you reach out to express interest in OT services at NESCA, Julie Robinson, OT, our department director, will have a personal phone call with you to help you through the process. As you conduct your search for the right fit for your child and family, here are some good questions you might ask to help you determine what works best. We’ve offered answers regarding NESCA’s services to let you know more about how we provide OT services.

What type of insurance do you take for occupational therapy?

Here at NESCA, we are in-network for BCBS and Allways, and we bill them directly on behalf of our patients.

How long are your OT sessions?

We spend 45 minutes directly with a child and another 5 – 10 minutes at the end of the session to consult with the caregiver. Other practices provide 30 or 38 minute sessions to compensate for decreases in insurance payments since the outset of Covid-19.

How long do we have to wait for an OT session? 

We can initiate an evaluation within 2 – 3 weeks of initial contact. If you have availability to bring your child in for treatment during the school day, there is no waitlist at this time. If you require sessions in the afterschool hours, there is a very small waitlist.

How many patients does a clinician typically see per week?

Some practices require their clinicians to perform as many as 30 or 32 patient hours per week to maximize their income. Here at NESCA, we cap patient hours at 26 per week. It is very important for us to focus on providing excellent clinical care to our clients with staff who are not burnt out or struggling to manage paperwork, treatment planning, and administrative activities, such as phone calls and emails to support our families. We are proud to offer research-backed services and want to provide our clinicians with ample time for continued opportunities for learning, allowing them to reach their highest level of potential and skill as a therapist – which they then pass on that knowledge and skill to our families.

What does your OT practice focus on?

At NESCA, our focus of therapy is based on a holistic view of a child to encourage life-long functional skill acquisition. We use a combination of sensory motor, sensory integration, developmental, and trauma-informed techniques, as well as practice and repetition of those techniques. We offer coaching on daily living skills to address weaknesses across a variety of areas: self-regulation, executive functions, self-care skills, such as dressing and bathing, handwriting and fine motor development, feeding, academic readiness, organization and attention. Other practices may utilize sensory integration or applied behavioral analysis as the basis for their program, for example.

Does the practice provide OT services in a clinical setting, remotely, at home, in school, or in the community?

Our primary service provision at NESCA is in the office or over teletherapy. In some instances, where schedules can be accommodated, we will provide services in the home, schools, or in the community. There may be additional travel fees involved for services outside of the office.

Does your OT practice offer comprehensive or second opinion evaluations for academic programming if needed?

NESCA does provide this service.

Will your practice consult with teachers or other caregivers if needed?

Yes. Sometimes additional fees are required, as insurance does not cover this service. We believe that consultation with outside providers is a critical part of our success!

Does your practice provide any specific programs outside of traditional sensory-motor based Occupational Therapy services?

At NESCA, we provide several specialty services in addition to traditional OT:

  • Feeding therapy
  • Safe and Sound Protocol for auditory sensitivity and self-regulation
  • Handwriting Without Tears
  • Trauma-informed Sensory Integration

What makes our clinicians so special?

One of the things that makes our occupational therapists an ideal match for your family is our love for children, the work we do, and our commitment to lifelong learning and the development of our clinical skills. Our entire OT department has known each other for at least four years, and we all came together as a team from another practice, with clinicians that are hand-picked by our director. We meet together on a weekly basis to share ideas and information, as well as to support each other in our clinical development.

For more information about NESCA’s Pediatric Occupational Therapy services, please visit: http://nesca-newton.com/occupational_therapy/ or submit an online Intake Form: https://nesca-newton.com/intake-form/.

 

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 or other clinical therapies, 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.

 

153

A Halloween for Those with Sensory Challenges

By | NESCA Notes 2021

By: Julie Robinson, OT
Director of Clinical Services; Occupational Therapist, NESCA

Halloween – a holiday full of tricks and treats. For some children, getting in the Halloween spirit by getting dressed up, carving pumpkins, and going trick-or-treating with friends is what they look forward to all year. For others, dressing up in an itchy costume, not being able to see someone’s face because they are wearing a spooky mask, being out in the dark with crowds of noisy trick-or-treaters, carving pumpkins and having to touch the oooey goooey insides of a pumpkin, and seeing decorations that make sudden noises or movements may make this holiday overwhelming for these children. Halloween can be tricky for families with children living with sensory processing difficulties, but with some creativity and planning ahead, families can build their toolboxes with their own tricks to combat the challenges that come with Halloween so their child can enjoy the treats that Halloween has to offer.

Here are some tricks for some common challenges that Halloween brings up:

Prepare for the day

Have an open discussion with your child about the traditions and activities associated with Halloween. You can read Halloween-themed books or watch Halloween movies (perhaps not the really scary ones!) to prepare your child for what to expect, because the anticipation of a new routine or anticipation of participating in unfamiliar activities can cause stress on a child. Discuss the plan for Halloween regarding decorations, attending parties, going trick-or-treating, etc., ahead of time so the child knows what to expect when celebrating the holiday. Consider the use of a visual picture schedule with activities that may be added into your typical routine. Provide ample warnings for transitions, when possible, to give your child time to move from one activity to another.

Be creative and imaginative with your child’s costume

The most important aspect of a costume for a child with sensory processing difficulties is ensuring that the costume is comfortable. Certain costume material may be itchy or scratchy, costumes with masks may occlude a child’s vision or be too tight on their head, or make-up may smell off-putting to a child. Children should have the opportunity to try on their costume when walking, sitting, and reaching for things before wearing it for real to make sure they are comfortable moving around in it. It is important to remember the idea of “less is more” and to use your imagination when coming up with costume ideas. For example, if a child wants to be a superhero, consider attaching a superhero logo to the front of a shirt they wear regularly rather than having your child wear a full superhero one-piece costume that may be itchy, tight, and hot.

Choose activities that best fit your child’s sensory needs

Meaningful participation in Halloween festivities doesn’t just include carving pumpkins and going trick-or-treating. Halloween activities can include roasting pumpkin seeds, setting out the candy bowl for trick-or-treaters, doing Halloween-themed crafts, etc. It is important for you to pick activities that best fit your child’s sensory needs. For example, if your child dislikes carving pumpkins because they have to touch the messy pumpkin insides, consider having your child paint their pumpkin or decorate it with stickers instead or make a pumpkin out of paper to decorate. If you and your child really want to go trick-or-treating but your child becomes overwhelmed with noisy crowds, consider trick-or-treating on only quiet side streets, or limit your time, allowing for breaks in between. If your child becomes overwhelmed with flashing lights, loud noises, or scary decorations, consider doing a drive-by of the neighborhood before taking your child out for trick-or-treating so you know which houses to avoid. For some children who crave a great deal of movement, it may be useful to engage in some heavy work activity before participating in a Halloween activity: wall push-ups, yoga poses, carrying weighty objects, for example. It may also be useful to engage in calming sensory activity to ease the transition from a busy setting back into the house: tactile materials like playdough or putty, water play, or a sensory table may be worth trying, or consider making a play tent or fort with quiet books or puzzles, or drawing to smooth the transition.

Monitor for overstimulation

Knowing when your child has had enough of Halloween festivities is just as important as knowing how to get your child engaged in them. A child may not be overstimulated at first, but may become overwhelmed minutes later. It is important to give your child choices of activities and next steps they can take as well as alerting your child about the sequence of events and the timeframe of events so that they know what to expect. If possible, help your child learn to advocate for themselves by saying things like, “please don’t touch me,” or “no thank you, I don’t want wear that,” in order to give them some autonomy over the activities that they participate in. However, in situations where this isn’t possible, it is important as the parent to know when to stop or disengage from festivities when sensory overload occurs and return home or to a quieter, more familiar space to give the child time to decompress.

Resources:

Enjoying Halloween With Sensory Challenges. (2021). Aota.org. https://www.aota.org/About-Occupational-Therapy/Patients-Clients/ChildrenAndYouth/halloween-sensory.aspx?fbclid=IwAR23ux4OKqJmXEZdnCIzb2_Uh0of55YKuCf8ek97UEAc1jZflndR_ZEBRwM

Morin, A. (2019, August 5). Halloween Challenges for Kids With Sensory Processing Issues and How to Help. Understood.org; Understood. https://www.understood.org/articles/en/halloween-challenges-for-kids-with-sensory-processing-issues-and-how-to-help

‌5 Ways to Help Children with Sensory Challenges Participate in Halloween Festivities. (2021). Aota.org. https://www.aota.org/Publications-News/ForTheMedia/PressReleases/2019/102419-Halloween-Tips-Sensory-Challenges.aspx

 

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 or other clinical therapies, 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.

 

153

Is It Sensory? Or Is It Behavior?

By | NESCA Notes 2021

By: Julie Robinson, OT
Director of Clinical Services; Occupational Therapist, NESCA

As parents or other caregivers of children with special needs, we can often find ourselves confused between what is a sensory response and what is behavior. Although this is often a complex question, and one without a straightforward answer, there are some tools of the trade that OTs use to help us determine just what is going on with these children. What makes this so complex is that each child is an individual, with their own unique ways of responding to sensory stimuli, to social interactions, and when out in varied settings in their community or with family. Children may also present differently from minute to minute or day to day, depending on sleep, hunger, and fluctuations in mood. But we can often look closely for patterns that may help to guide us in finding the answers.

When working with a child who seems to be in a meltdown, one of the best things you can do is take a quick scan of the environment. Is there a loud or distracting sound in the background? Did someone touch the child unexpectedly? Is the overall environment too busy and overstimulating, such as at party or a restaurant? Sometimes just naming or removing the stimuli, if possible, is enough to help get things back under control. If you know a triggering situation might arise that provokes a meltdown, see if you can give the child a warning and a plan of where to go for comfort. “We will be having a fire drill in 10 minutes, so when it happens you can hold _____’s hand, or we can get you some headphones to cover your ears to make you more comfortable” is one example. Find something soothing from a sensory perspective to help the child settle: a quiet corner with books, some tactile play or fidgets, calming music, a tight squeeze ( but only if tolerated and given permission to do so ). If you know you are entering a highly stimulating environment, it may be best to go in for short periods, with frequent breaks built in for your child every 10 minutes or so to take a walk, use the bathroom, or get a drink.

If you do not see something sensory in your environment creating the discomfort or the meltdown, then behavior and emotions are more likely at play. You child may feel confused about a social interaction, about expectations, or what may be coming next in a transition. Your child may feel a lack of confidence or anxiety in a situation, that although may be seemingly simple and straight forward to you, may not to him or to her. An academic task may feel misunderstood, and not knowing how to start can result in a meltdown for many of our children.

When you see that the child you are caring for is beginning to ramp up, that is the best time to intervene. Once a meltdown has begun, language processing will be limited, and the child may not be reachable for a period of time in order to settle down. The best thing you can do in those moments, is to help the child to stop. I often use a stop sign to hold up in my therapy sessions, that cues the child to take a quick break from interacting with me when I see things starting to spin out of control. I limit my language, provide a calming sensory activity, then we can talk about the upset once I have the child back in my court.

Here are some things to think about and questions you might ask yourself to help guide your interactions and expectations when you, as the adult, are confused about whether this is sensory or behavior:

  1. What are the undesirable behaviors that my child observes when he or she is upset or uncomfortable? Are they different when there is sensory discomfort, in comparison to when he or she is upset with a person or a demand? Notice quality of voice, bodily tension, inability to stay still or focused, aggression, flight or an attempt to get away, shutdown or inability to interact. You may start to see patterns in behavior when you look at them in relation to a sensory event or something that is more emotionally-laden.
  2. What occurred just before this behavior appeared? Was there a sensory distraction or discomfort or was he or she upset with a person or a demand?
  3. How did the child behave during this episode?
  4. How did adults or peers interact with my child during the episode? Did it calm the child, or make him or her more agitated?
  5. List sensations that may have triggered a meltdown: tactile, auditory, visual, smell, taste, movement. Were they loud, distracting, uncomfortable? Was the child in a space that may have been too small or too large? Was the child able to get away from the uncomfortable stimuli, or did he or she feel stuck in the moment?

It will be beneficial for team members to share information and write these things down, perhaps in a format of a journal, so that the team can work together to uncover the patterns, find strategies that are successful, and provide consistency across the board. We all know consistency for these children is one of the most effective tools for learning, and although it may take some extra work up front for caregivers, the pay off on the other side is often so rewarding that it is worth the effort.

If you would like to explore this topic further with NESCA OT Julie Robinson, join us for a free webinar on this topic on September 13, 2021 at 10:30 am ET. Register in advance for this webinar at:

https://nesca-newton.zoom.us/webinar/register/WN_-edHNIwkRBKnjk0gq6-bUw

 

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 or other clinical therapies, 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.

 

152

Mind the Gap: Why You Should Consider Summer OT and Speech Services at NESCA

By | NESCA Notes 2021

By: Julie Robinson, OT
Director of Clinical Services; Occupational Therapist, NESCA

It has been a challenging school year, with ever-changing schedules, routines, and unfortunately with a good deal of inconsistency in the provision of therapeutic services through the schools, due to the many impacts of COVID. Parents, caregivers and students have all experienced differing levels of anxiety about what progress has been and is being made, with many children experiencing some level of regression with regard to behavior, self-regulation, motor skills or language development. In anticipation of many of our children returning to school in-person in April, parents have expressed concerns that their children may be lagging behind or that they have not had ample support throughout the earlier parts of their school year to ensure they can keep up with the other children in their class. Over the months of April, May and June, we will all get to see firsthand where the gaps might arise. And then when school is over, many of us might be concerned that the gains of just a few short months will be lost again over summer. This is why those of us at NESCA perceive that the benefits of summer services will be an important part of ensuring progress and the ability to jump right back into learning – as we hope all school will be in-person again in the fall.

NESCA is available to provide summer services, as we do consistently for our weekly patients. In addition, we are offering short-term services to those children who may not qualify for them through their school systems, or for those families who would simply like to supplement what their children are receiving in-district to give them a boost before school begins again in the fall.

Our occupational therapists (OTs) can work on the following areas of focus with your child:

  • self-regulation and coping skills
  • how best to transition from the quiet of home to the multiple stimuli of a classroom full of children
  • how to cope with longer hours of wearing a mask
  • how to follow social distancing requirements, when they long for a closer physical connection with their peers

We can also help to ease the anxiety some children may have about becoming sick or how NOT to feel fearful of getting back into the classroom when sensory processing issues push them to feel uneasy. Our OTs can continue work on handwriting and motor development work started throughout the school year to ensure there is no regression or to improve the speed and automaticity of written expression and legibility. We can teach organizational and executive functioning skills to encourage kids to be independent, prioritize assignments and manage their time. OTs can address self-care skills of dressing, shoe tying, feeding and hygiene, which are likely to require more independence with social distancing requirements. While it’s summer, we help build outdoor skills, such as bike riding and greater self-confidence on the playground to elicit more social connections with peers. Our OTs are providing services in-person in our Newton and Plainville, Massachusetts clinics, by teletherapy or outdoors in the community as appropriate.

Our speech therapists at NESCA can also help to continue and supplement the hard work children have been putting in throughout the school year. They can work on social pragmatics and help with the skills needed to transition from so much time alone, to being in groups with their peers once again. NESCA’s speech therapists can support children on how to:

  • initiate play
  • find shared interests
  • be flexible thinkers
  • communicate with kindness and an appropriate level of voice
  • read gestures and non-verbal communication (especially while wearing masks, which can impede the ability to properly read another person’s mood, reactions or emotions)

We can continue to work on the established goals from school, regarding both expressive and receptive communication, language articulation and language as it pertains to written communication. Our speech therapists are currently providing all services via teletherapy while we work on a transition back to in-person therapy.

If you are interested in seeking out summer services at NESCA, or any of our assessments and services, please contact NESCA’s Director of Clinical Services Julie A. Robinson. She can be reached at jrobinson@nesca-newton.org and will conduct a phone intake with you to help you best determine your needs.

 

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 or other clinical therapies, 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.

 

150

Movement Breaks – Part 2

By | NESCA Notes 2020

By: Julie Robinson, OT

Director of Clinical Services; Occupational Therapist, NESCA

In our last blog, we delved into ideas and suggestions to help preschoolers stay on track with remote and hybrid learning through movement breaks. In this week’s OT Tuesday blog, we move up to our elementary school-aged kids. How do we keep them focused on online learning throughout their long days at home in front of a computer?

Again, here are some suggestions that require minimal equipment, generally using things you can find around your home.

 

Gross Motor for Elementary-age Children

A movement break for 5- to 10-minutes every hour and a half to 2 hours is recommended.

Hopscotch – Draw with chalk or use painter’s tape and play this old school game! Begin by throwing a beanie baby, rock or bean bag so it lands in the first square. Hop over it and jump on all the other squares. At the end, turn around and come back and try to pick up the object while trying to balance on one foot! The next time, throw the object to square 2 and repeat through all the numbers!

 

Photo Credit: sciencebuddies.org

Homemade Hockey Sticks – Use a long wrapping paper roll or tape together paper towel rolls as the handle. Cut a long strip of cardboard and tape to the handle or use an old plastic water bottle. Enjoy playing this game with a balloon or tennis ball. Mark goals with tape, chalk or use empty cardboard boxes.

 

Stack the Cardboard Boxes – Got empty boxes? Have the child stack them up high and knock them over by running into them, or rolling/kicking a soccer ball into them. To make it a little silly, place a tennis ball in the leg of a pair of stockings and the waistband over your child’s head. Use the tennis ball to knock over boxes or cans, with their head upside down.

 

Photo Credit: Hands On As We Grow®

Stair Bean Bag Toss – Try to get bean bags to land on different steps. More points for the higher they land!

 

Tic Tac Toe – Make a big board with sidewalk chalk or painter’s tape. Use bean bags, frisbees, paper plates or crumpled up paper and throw into boxes for a fun spin. Get creative with items around the house – even food!

 

Photo Credit: OT Plan

Belly Catch – Have your child lay on their belly with feet or legs resting on a couch and hands on the floor (plank style). Roll balls or balloons and have them play catch with you, a great exercise to work on core and upper extremity strength.

 

 

 Fine Motor for Elementary-age Children

Photo Credit: Hoglets.org

Monster Feet – Grab some old tissue boxes or cardboard and make your own monster feet. Decorate the toe nails with markers, pom poms or however else you’d like! For an added challenge, try wearing them by using string to tie the child’s feet to them. Or tape their shoes to them and walk around like a monster!

 
Photo Credit: kidsactivitiesblog.com

Homemade Tennis Racquets – Cut slits in a paper plate or punch holes. String yarn through the holes and attach to a paper towel roll, spatula or wooden spoon/popsicle stick. Use it to keep a ball or balloon in the air!

 

Hangman! – Or for an added twist, play Melting snowman! Draw a snowman, and each time someone guesses a letter incorrectly, erase a part of the snowman until he is fully melted!

 

Make Your Own Quicksand – Mix roughly equal parts cornstarch and play sand. Add water until it is the desired consistency.

●       If you don’t have play sand, add 1 cup of water to a bowl and slowly add 1-½ cup of cornstarch and stir.

●       Put toys into quicksand and watch them sink!

 

Paint Pinecones – As the weather gets colder, collect some pine cones or rocks and paint them! Make kindness rocks by writing messages on them with a Sharpie. Leave them out along a wooded trail for others to find.

 

 

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.

 

150

Movement Breaks – Part 1

By | NESCA Notes 2020

By: Julie Robinson, OT

Director of Clinical Services; Occupational Therapist, NESCA

Many parents are overwhelmed, juggling homeschooling, childcare and work from home. And now that the cold weather has arrived, many parents are looking for activities they can do indoors with their children as movement breaks to support online learning or just to pass some time and get the wiggles out. Here are some suggestions that require minimal equipment, generally using things you can find around your home.

In this week’s OT Tuesday blog, we provide suggestions on both gross and fine motor activities for preschoolers. In our second part of the blog series, we will offer ideas to target fine and gross motor activities for elementary school-age students during movement breaks.

 

Gross Motor Activities for Preschoolers

A 5- to 10-minute movement break is suggested every hour to hour and a half for children in this age group.

Balloon Games – Blow up and see how many times your child can hit the balloon in the air! Use a fly swatter or tennis/badminton racquet to mix it up a little.
Mazes – Use painter’s tape indoors or sidewalk chalk outdoors in the driveway to make mazes for your child to follow. You can even use the lines as a balance beam for added balance practice, draw feet to jump in, make curly lines to indicate twirling around, etc.! If you are looking for ideas, research sensory paths online. You can also draw crazy roads for toy cars or ride-on toys.
Bowling – Fill up old plastic water or soda bottles and have kids knock them over by rolling a ball towards them! You can add stuffed animals on top to make it more enticing.
The Floor Is Lava – Pretend the floor is lava and have the child walk around without touching the ground by walking on pillows and other objects!
Shape Games – Draw shapes, letters or numbers with sidewalk chalk or painter’s tape and try throwing stuffed animals into the shapes an adult calls out. Make it more challenging by increasing the number of shapes, throwing from further away or trying to balance on one foot while throwing.

 

Fine Motor Activities for Preschoolers

Hide Beads In Playdough! – Grab some putty or playdough and hide beads in it. Once all the beads are hidden, encourage your child to try to get them out! This is a great exercise to work on hand strength. It can also be fun to put raw spaghetti into the dough and “string” the beads onto them for working on fine motor precision.
Make Your Own Stamps! – Use household items, such as wine corks, water bottle caps, toilet paper rolls or anything else you can find. Dip them in paint and press onto paper. Enjoy the different shapes you create! For picky eaters, it can be fun to use foods, such as applesauce, yogurt or dips for paint.
Clothespin Activities – Use clothespins to pick up pom poms and put them in containers, such as an ice cube tray. This is a great activity for practicing a tripod grasp.
Shaving Cream Play – Use a tray or large plate and put shaving cream or other messy play materials on it. Allow your child to practice writing their letters with their fingers and have fun with it! To simplify, you can encourage your child to imitate shapes, letters or numbers after you have written them.
Noodle Necklaces – String noodles onto string to make a noodle necklace. Use noodles and put on a string or a pipe cleaner to make a necklace. Color or paint noodles, or soak cooked noodles in food coloring and allow them to dry for more interesting patterns.

 

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.

 

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

NESCA’s New OT, Speech & Language and Feeding Services

By | NESCA Notes 2020

An interview between Sophie Bellenis, OTD, OTR/L, NESCA Occupational Therapist; Real-life Skills Program Manager and Coach, and Julie Robinson, OT, NESCA

NESCA just announced that it has expanded its Occupational Therapy (OT) services to include Direct Sensory-/Motor-based OT for its existing and new clients.

As you may know, NESCA already offers educational OT assessments and consultation along with Executive Functioning (EF) and Real-life Skills Coaching, mainly for those students in grades 6 and up. Now, NESCA broadens the range of students it can provide with OT, feeding, speech, language and social skills.

To introduce NESCA families and community members to the new team and its services, NESCA’s Sophie Bellenis, OTD, OTR/L, sat down for an interview with Julie Robinson, OT, to learn more.

What is the main focus of the new OT services that we are adding here at NESCA?

We are so excited to be on board and collaborating with the existing clinical team at NESCA to bring these new services to our community. The main focus of the new OT services is to provide instruction and practice, through teletherapy, and when appropriate at the home or in the community, in order to promote the best functionality kids can achieve on a daily basis. Where academic-based occupational therapy is focused on accessing the curriculum and receiving services while at school, Direct Sensory-/Motor-based OT services really look at giving our clients those wrap-around services outside of school to help with sensory processing, self-regulation, attention/following directions, fine and gross motor skill development, social pragmatics, managing routines, feeding and independence in carrying out daily activities, such as dressing, hygiene and sleep.

Who is a candidate for these new OT services?

We work with children of all ages, but our team typically works with children who are in the fifth grade or below. Many of the skills we are working on are skills that should be targeted and developed early on. Ideally, we are working with children from a young age or as soon as the challenges noted above come to light. Children with motor delays or sensory processing disorders, delays with play skills, and/or feeding difficulties are appropriate for these services.

How does the process of getting OT services start?

We usually start with an OT assessment that is focused on function. Insurance typically covers a 45-minute in-office screening. We would typically conduct a phone intake with the family, then look at the child’s skills using standardized tests for motor/sensory performance. With COVID-19, we are gathering sensory information from The Sensory Processing Measure and assessing other skill levels through interviews and checklists from parents, as well as 1:1 observation either virtually or in-person, as determined through the phone intake.

After an initial assessment is conducted, we work with families on a once or twice weekly basis. Each OT session is 45 minutes long and generally either begins or ends with a conversation with parents.

How do the services work?

We would typically provide services in-person inside the OT clinic at NESCA. Due to COVID-19, we are primarily providing services through telehealth, on a HIPAA-compliant virtual platform on a weekly basis. Sessions are 45 minutes each, with parents involved in part of each session to facilitate engagement of the child, to be coached by the clinician and for education about activities to incorporate in the days before the next session for follow through.

A small number of patients are being seen outdoors at their home or in the community, mainly when online engagement is too challenging, and when it can fit accordingly into clinician schedules. All patients are being seen individually for their services.

How do you set goals for the children you work with?

We get some of our background information for goal-setting from the assessment, but much of the real information on goals, strengths and weaknesses is revealed through observation during our sessions.

From the initial evaluation, we develop a brief report identifying the areas that we need to work on and collaborate with the parents to help achieve those goals and potentially target other areas that arise through ongoing observation and informal assessment during sessions and in parent consults.

When can families expect to see progress with goals being achieved?

We like to see our established goals being achieved in a three to six month time period. While every child is different, many kids go on to work with us for approximately 12 to 18 months, focusing on various goals throughout that period.

What are the related services that have just been introduced at NESCA?

Along with our new occupational therapy services, we are also now providing assessment and treatment of a variety of Speech & Language disorders, including dysphagia, childhood apraxia of speech, phonology/articulation disorder, receptive and expressive language disorder, social pragmatic communication disorder, autism spectrum disorder and language-based learning disabilities.

In addition, our therapists work with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake, and reducing avoidance behaviors during mealtimes. Our feeding therapists work with families to make mealtimes easier and more enjoyable for everyone using a systematic desensitization approach to increase sensory comfort with foods. We also employ the TR-eat®—Transdisciplinary Effective Assessment and Treatment—method for highly challenging feeding and eating issues.

Does NESCA accept insurance for its new services?

Direct Sensory-/Motor-based OT at NESCA (not academically-focused), is covered by BCBS and AllWays. Speech therapy at NESCA is covered by BCBS, AllWays and Harvard Pilgrim.

NESCA can provide receipts for Direct Sensory-/Motor-based OT sessions for clients to attempt to submit to their insurance carrier, should they not have insurance through the above carriers. NESCA does not submit claims to any carrier other than those outlined above and cannot guarantee any reimbursement when claims are submitted to them by the client.

It is also worth noting that Educational OT assessment, consultation and treatment is less often, or less completely, covered by insurance because insurance carriers typically only cover treatments that are deemed “medically necessary.” However, this can be a vital service because students spend such a significant amount of their day and week in school programming.

To learn more about NESCA’s Occupational Therapy and Related Services, please click here.

 

About the Interviewer

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.

About the Interviewee
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.