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Lauren Zeitler

Bringing OT Activities Home for the Holidays

By | NESCA Notes 2021

By: Sarah Attanasio OT/s and Lauren Zeitler, MSOT, OTR/L
NESCA Occupational Therapist; Feeding Specialist

With the holiday season in full swing, families will soon be faced with the significant routine change that comes with school vacation. During this time, it is important to continue working on skills gained and techniques learned during school and therapy. Occupational therapy (OT) sessions often include activities to promote different skills, including visual perception, sequencing problem solving, and more! OTs also utilize movement activities to target sensory modulation, bilateral coordination, and force modulation to name a few. Here are some functional activities to do with your children at home to continue promoting skills learned in school and therapy while still getting into the holiday spirit.

Setting the table

OT skills addressed: visual perceptual skills, bilateral coordination, task sequencing, problem solving, force modulation, attention

Setting the table is an easy and functional way to promote the above  essential life skills in the home environment. First, this task requires children to problem solve and decide what items they need to set the table. Children then  scan their environment to locate and gather all necessary items. Next, children must safely carry all items to the table, which typically requires them to use both hands together. While doing this, they also scan their environment to make sure there are no obstacles in the way. Finally, children have to use an appropriate amount of force when placing items onto the table to ensure that these items do not break. They have to pay attention to the task at hand and problem solve where the correct spot on the table is for these items. To make this easier for children, try focusing on fewer skills, such as providing them with a picture of the proper place setting or laying items out on the counter already. To make this harder for children, have them carry heavy items to the table, such as a full pitcher of water or create obstacles for them to avoid on their way to the table.

Baking cookies

OT skills addressed: meal prep skills, task sequencing, direction following, tool usage, bilateral coordination, force modulation, sensory integration

Baking cookies is not only an entertaining activity for children, but it also promotes many important life skills! Making cookies requires children to follow the directions of a recipe. It also requires children to pay attention and appropriately measure the correct amounts of ingredients. They also have to explore how to appropriately and safely utilize various tools, such as a measuring cup, whisk, spatula, cookie cutters, a hot baking tray, etc. Cookie dough may be an unpleasant texture for some children since it is gooey or sticky. This activity gives children the opportunity to explore an unpleasant texture and trial strategies, such as wearing gloves, taking deep breaths, taking turns manipulating dough, etc., to better tolerate interacting with various unpleasant textures. Rolling the dough using both hands together and utilizing cookie cutters are two great ways to encourage bilateral coordination and increase hand strength. To incorporate more skills into this activity, such as visual perceptual skills, have your child decorate the cookies with icing and/or sprinkles making sure they stay within the boundaries of the cookie.

Decorating with paper snowflakes

OT skills addressed: task sequencing, visual perceptual/motor skills, bilateral coordination, scissor skills, coloring skills, hand eye coordination, hand strengthening

Paper snowflakes are a holiday decoration staple, and the process of making them promotes various  life skills. First, this task requires children to problem solve what kind of design they want their snowflake to be and fold the paper accordingly. They then are required  to use their hands together to cut out their desired design while holding the paper in one hand and the scissors properly in the other hand. Try having your child draw a pattern on the snowflake for them to follow while cutting or coloring in their snowflake within the boundaries. This can be done once it is cut out to further promote visual perceptual/motor skills and hand eye coordination.

Writing cards 

OT skills addressed: handwriting skills (grasp, letter formation/line placement/sizing/spacing/legibility, writing utensil usage, handwriting posture)

A handwritten note is a simple gesture that is always appreciated by all. Writing cards allows children to practice their handwriting skills in a functional way at home. First, it is important to maintain proper posture when doing any handwriting activity. Proper handwriting posture follows the 90-90-90 rule: feet are flat on the floor with ankles forming a 90-degree angle with the floor. Knees are bent at a 90-degree angle, and the hips and torso form a 90-degree angle. Using an elevated/slanted surface is also helpful in placing children in the optimal 15 degrees of wrist extension for handwriting activities. To promote proper grasp, have your child use broken crayons or a grip on their writing utensil. Provide your child with lined paper so they have a visual of where to place letters. The addition of a “worm line” underneath the bottom line is sometimes helpful for placing letters, such as g, j, p, q, and y. If handwriting is too high of a skill for your child, have them draw a picture including shapes, such as squares, triangles, and circles as these are necessary pre-writing skills to master.

Playing family games

OT skills addressed: rule following, turn taking, cooperative play

What better way to bond as a family than a family game night?! Games are great for children as they require rule following, tolerating an occasional change of rules, tolerating winning/losing, and turn taking. Many games also incorporate essential fine motor skills in terms of functional grasp, such as hi ho cherry-o, candy land, mancala, etc. and gross motor skills, including   balance and coordination with games like twister, yoga games, ring tosses, etc.

Play in the snow

OT skills addressed: sensory modulation, force modulation, gross motor skills, proprioceptive input for body awareness

If we are lucky enough to get snow this holiday season, playing in the snow is a great, versatile activity for children. Have children engage in a friendly snowball fight or throw snowballs at targets. This will promote hand eye coordination and force modulation ensuring that they aren’t throwing snowballs too hard to the point where they hurt someone or break something. Have children make snow angels to promote bilateral coordination and body awareness. Ask them questions like: Does the snow feel cold or hot on your body? Where do you feel the snow on your body? Is the snow wet or dry? Does the snow smell/taste/sound like anything? This line of questioning promotes body awareness and sensory modulation. Shoveling snow is also a great functional (and helpful!) heavy work activity that provides children with proprioceptive input (pressure on their joints) to help them better understand where their body is in space and promote overall body/spatial awareness. Another great heavy work activity is making a snowman, as it requires children to use both of their arms together to push large, heavy balls of snow along the snow-covered ground. The possibilities of functional activities involving snow are endless!

This list offers just  a few ideas of the many activities you can do with your children over school vacation. Many activities and games can be therapeutic and easily graded to any child. The trick is to find the just-right challenge to work on the skill area desired through fun and motivating means. We recommend reaching out to your occupational therapist for more activity ideas to motivate your child over break!

 

About the Author

Lauren Zeitler is a licensed Occupational Therapist in Massachusetts, specializing in pediatric occupational and feeding therapy. Ms. Zeitler joined NESCA full-time in the fall of 2020 to offer occupational therapy assessment and treatment for children of all ages, as well as to work in conjunction with Abigael Gray, MS, CCC-SLP, on the feeding team.

 

 

 

 

 

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.

 

Back to School: Tips for the Sensory-savvy Parent

By | NESCA Notes 2021

By Lauren Zeitler, MSOT, OTR/L
NESCA Occupational Therapist; Feeding Specialist

Just like that, summer is over and it is finally time for children to head back to school! This year might look a little different as we move from remote learning and ease back into the school building full time. For children with sensory processing issues, the school building poses a great deal of anxiety as they try to deal with various sensory stimuli. The noisy bus, smells of the cafeteria, and visually overwhelming classroom are just a few examples of the daily overstimulating experiences a student with sensory processing issues encounters. Don’t fret! We will break down the school day and the core sensory systems that are impacted along with strategies to help your student succeed.

Starting the Day: Auditory Processing

As the day starts, many children hop on the bus and ride to school. This means they are encountering a noisy, chaotic vehicle filled with many other children. You might see kids respond negatively by running away, crying, or holding hands over their ears to block out the noise. Startling easily, the bus ride can be a stressful start that will set the tone for the rest of the day for students with sensory issues. It is important to utilize different strategies to prepare your child for the bus. Try these ideas to help with auditory processing:

  • Provide over the ear noise canceling headphones to wear on the bus ride
  • Provide calming music on an iPod, etc. to listen to during bus ride
  • Wear a weighted vest or lap pad during bus ride
  • Provide heavy work input to the student’s body in the morning before entering the bus

Learning in the Classroom: Visual Processing

Walking into the classroom, there are bookcases lined up, posters on the walls, desks in rows, and lots of bright lights. When it comes to visual processing, children respond in different ways. Some children avoid these stimuli, while others seek out visual input. Squinting, blinking, and covering their eyes are just some of the quick fix responses to the bothersome lights. Some kids have trouble paying attention if there are too many things to look at. To some children, the flickering lightbulb in the corner of the ceiling is much more interesting than whatever the teacher has to say. It is very easy to become distracted and overwhelmed in the visually overstimulating classroom environment. Teachers: try these strategies to help with visual processing:

  • Remove distracting posters, pictures, etc. from the walls
  • Place busy bookcases, lockers, etc. in the back of the room
  • Have easily visually distracted children sit in the front of the room closest to the board
  • Provide a calming corner with a sensory bin filled with items, such as noise cancelling headphones, stuffed animals, lavender lotion, books, etc.

Time for Art Class: Tactile Processing

It is time for art class, and your child freezes at the doorway refusing to enter the room. Glitter and glue are everywhere, and the fear of being dirty strikes again. The feeling of touching messy media can send some children into panic fight or flight mode. This goes well beyond art class’s requirement to interact with different media, often branching out and impacting their ability to participate in social experiences, such as playing on the playground. To avoid overstimulation, prepare your child’s body with these strategies:

  • Prepare the student before art class by reviewing the schedule
  • Provide heavy work breaks, such as wall push-ups before entering the art room
  • Provide a weighted vest or lap pad to use during art class
  • Find adaptations to the art project to decrease interaction with sticky substances (i.e., using glue sticks, spoons to spread glitter, etc.)

Lunch in the Cafeteria: Olfactory and Gustatory Processing

It is now time for lunch. As your child walks into the cafeteria, they look around to find their friends and are greeted with a really strong smell. What is that?! Your child is no longer looking for their friends; instead, they are trying to find a way out because the smell is too overwhelming. Try these strategies to help kids with sensitive noses:

  • Find a place in the cafeteria that your child can eat away from the food serving area (where the smells are the strongest)
  • Provide an essential oil patch or roller ball that the student can smell to calm their body and move their focus away from the cafeteria smell
  • Use essential oils, such as lavender or eucalyptus, which help calm
  • Provide heavy work opportunities before entering the cafeteria to help organize the body

Once your child has gathered their food and found the best place to eat, they sit down and look at their meal. Oh gosh – why does it look so squishy? This sandwich is slimy – that is a big no! The gustatory – or taste system – kicks in, and it does not appear happy. What can we do to help kids with sensitive taste systems? Try these strategies to help make mealtime easier:

  • Provide lunch from home to help control what options the child has to eat during the day
  • Provide crunchy food items, such as pretzels, raw veggies (carrots, peppers, cucumbers, etc.), or popcorn to promote “heavy, organizing input” to the mouth and jaw
  • Provide thick drinks, such as smoothies, to drink through a straw
  • Promote drinking water through a water bottle with a mouth piece, such as those from Camelbak
  • Provide a special treat, such as licorice, Twizzlers, or sucker candy to provide alerting and organizing input

Gym Class Makes Me Nervous: Vestibular and Proprioceptive Processing

Afternoon gym class has arrived, and your student is too afraid to participate. Bumping into the wall, being hit by a ball, or playing in a coordinated group activity is hard for some children. Echoing voices and shoes squeaking on the floor, bright colors and moving objects are enough to overstimulate anyone. With the right environment, gym class can be fun for everyone! Here are some strategies to help with vestibular and proprioceptive processing in gym class:

  • Provide the opportunity for the student to leave the gym. Let them know that if the class becomes too overwhelming they can ask the teacher for a break. Going for a walk to the bathroom or grabbing water is a great, brief break.
  • Adapt games or activities as necessary. Students will be at different skill levels, and physical activity can present unique challenges. Provide simpler options when possible.
  • Create space boundaries. Using visual cues for personal space, and working in small groups can relieve anxiety. Visual cues may also be helpful in showing children where they should position themselves for games and exercises.
  • Provide activities that promote consistent, linear movements instead of sporadic, rotational movements, to help keep these sensory systems organized.

Remember to keep school fun! The school day is where kids spend most of their week, and we want to ensure they have the best experiences possible. Recognize that not all students with sensory processing issues will have the same strengths and difficulties. Meeting a student where they’re at and discovering their specific strengths is the greatest way to set them up for a successful school year! If you have any questions or to learn more about occupational therapy services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

About the Author

Lauren Zeitler is a licensed Occupational Therapist in Massachusetts, specializing in pediatric occupational and feeding therapy. Ms. Zeitler joined NESCA full-time in the fall of 2020 to offer occupational therapy assessment and treatment for children of all ages, as well as to work in conjunction with Abigael Gray, MS, CCC-SLP, on the feeding team.

 

 

 

 

 

 

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.

 

ADHD: Setting Up A Successful Environment

By | NESCA Notes 2020

Co-authored by: Lauren Zeitler, MSOT, OTR/L, NESCA Occupational Therapist; Feeding Specialist, and Lindsay Delling, OTS, Occupational Therapy Graduate Student

Before any assessments, treatment planning, or suggestions of adaptations take place, we must first understand what attention-deficit/hyperactivity disorder (ADHD) in childhood means, and how it may present and affect each individual child. The American Psychiatric Association defines ADHD as one of the most common neurodevelopmental disorders affecting children, with symptoms including, “inattention (not being able to keep focus), hyperactivity (excess movement that is not fitting to the setting) and impulsivity (hasty acts that occur in the moment without thought)” (2017). There are three different types of ADHD: inattentive type, hyperactive/impulsive type, or combined type, that come with specific criteria within each to provide a diagnosis. While some symptoms of ADHD are common amongst young children, such as difficulty sitting still or limited attention spans, the difference in children with ADHD is the inability to control it without external forces providing regulation for them. This blog post will outline the sensory systems and will provide environmental suggestions and adaptations for children with ADHD to help them succeed and increase focus!

It is estimated that 8.4% of children have ADHD; so, that being said, what can we as occupational therapists recommend to enhance attention and regulatory strategies in children with ADHD using the sensory systems as a guide?

  1. Touch – Children with ADHD may actually scientifically benefit from utilizing fidget toys to increase their attention to a task. This thought process comes from the fact that using a fidget toy, such as a fidget spinner or some putty, allows children to exert some energy while also keeping their hands busy. This then makes them more likely to attend to another task, such as listening to a teacher speak, because they have sustained alertness while working with the fidget toy and can therefore sustain attention to the overarching task. We have seen this in most people on a smaller scale as they twirl their hair or tap a pen while attending to a task; they are essentially using these items as fidget toys to enhance their alertness and sustain attention to the task at hand (CHADD, 2021). The same can be said for a wiggle seat cushion or chair to promote seated movement so the child can gain that sensory input of movement, while staying seated and attending to the task.
  2. Sight – Because children with ADHD exhibit hyperactive tendencies, this means that they are likely hypersensitive to lighting and types of lighting within environments, such as fluorescent lighting which is prevalent in many school systems. Providing children with ADHD breaks from this harsh light and allowing time for their eyes to relax is a great way to promote improved attention throughout the school day. Hypersensitivity in sight is also important to be aware of regarding any schoolwork a child may be doing. If there is a lot going on within the page, a child with ADHD can become easily overwhelmed and may be quick to abandon the activity due to overstimulation. Covering portions of the page so that the child can only see one activity at time may be helpful in keeping them focused and on track and will likely decrease frustration.
  3. Hearing – Due to the hypersensitive nature of children with ADHD, sounds can be very distracting for them when they are trying to focus on a task. One solution would, of course, be to find a quiet space for them to complete schoolwork and other activities. This, however, may not always be readily available or even an option. In that case, providing these children with other adaptations, such as noise cancelling headphones, while they complete their work or even just frequent noise breaks and allowing them to take a walk or play with a preferred item can be great alternatives in promoting sustained attention in a noisy environment!
  4. Smell – Just like the other senses, certain smells can also become overwhelming and even distracting for some children with ADHD. This can happen for many reasons, such as smells of food reminding them how hungry they are at school, smells that make them think of a certain memory that promotes daydreaming, or even simply gross smells that the child cannot seem to get their mind off of. To promote sustained attention and a calming effect with children with ADHD, essential oils can be a good option to trial! While they are not scientifically proven to directly help with symptoms of ADHD, they are proven to ease anxiety and stress, which can occur with ADHD. Scents such as lavender, vetiver, and chamomile are known for their stress-relieving abilities that promote relaxation and serenity within the body.
  5. Taste – Snacks…a fun way to wrap up this post! Similar to fidget toys, crunchy snacks can also provide attention-enhancing qualities when eaten during a time where sustained attention is necessary. The child will be focused on the task of chewing the crunchy item, such as carrot sticks, an apple, or some chips, and will therefore be present in the moment and better able to attend to the task going on around them. This strategy can be used in a variety of settings where eating is appropriate – school, home, tutoring, etc. And, it’s a fun contribution to the repertoire of strategies to enhance attention and self-regulation strategies!

As always, we recommend reaching out to your occupational therapist or getting an occupational therapy evaluation. Contact NESCA’s Director of Clinical Services Julie Robinson, OT, to learn more at: jrobinson@nesca-newton.com.

References

https://chadd.org/adhd-weekly/fidget-toys-and-adhd-still-paying-attention/#:~:text=Putty%2C%20squeeze%20toys%2C%20fidget%20cubes,classroom%20without%20becoming%20a%20distraction.

https://www.psychiatry.org/patients-families/adhd/what-is-adhd

 

Lauren Zeitler is a licensed Occupational Therapist in Massachusetts, specializing in pediatric occupational and feeding therapy. Ms. Zeitler joined NESCA full-time in the fall of 2020 to offer occupational therapy assessment and treatment for children of all ages, as well as to work in conjunction with Abigael Gray, MS, CCC-SLP, on the feeding team.

 

Lindsay Delling is a graduate student at Regis College working toward obtaining her master’s degree in occupational therapy. She previously completed fieldwork at Spaulding Rehabilitation Hospital in Charlestown and many school-based settings before coming to finish her fieldwork with NESCA. Prior to graduate school, Lindsay worked with children with disabilities in the Boston Public School system, as well as in a special education preschool setting in her hometown. Lindsay is open to working with many different populations once she completes her degree.

 

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.