Tag

sensory processing

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.

 

Learning to Ride a Bike: A Rite of Passage

By | NESCA Notes 2021

By: Jessica Hanna MS, OTR/L
Occupational Therapist, NESCA

If there is one positive takeaway from the COVID-19 pandemic, it’s the ever-growing love for being outdoors. It’s spring, the flowers are blooming, the sun is out, and the air is light. Everything in our body is telling us to go outside and play.

For many kids with and without disabilities, bike riding is meaningful, liberating, and a rite of passage. Close your eyes and try to remember the first time you rode a two-wheel bike. Can you remember the color of your bike? The smell in the air? The complete joy it brought you? That was the day we all felt a bit more confident and like we grew a bit taller.

So how do we help our children achieve this meaningful occupation? The days of running behind our children while holding onto their bike seat, telling them to pedal, not to stop, and hoping for the best and that they will forgive us when we let go (when we clearly promised we would not let go!) should be far behind us. But are they?

A lot goes into learning how to ride a bike, so do not let your child give up so soon when it takes more than a couple of days, weeks, or months to get it right. Consider the following skills that are addressed in learning to ride a bike:

  • Attention and concentration
  • Bilateral coordination
  • Balance
  • Body awareness
  • Core strength
  • Hand-eye coordination
  • Motor planning
  • Postural stability
  • Sensory processing
  • Upper and lower extremity strength
  • Visual scanning

Children as young as five years of age will begin to acquire and develop the skills needed to ride a two-wheel bike, and still others may not feel ready until they are pre-teens or even into adulthood.

Before getting started, here are a couple things to consider regarding the equipment involved in learning how to ride a bike:

  • Bike – The height of the bike is a crucial element to success when learning how to ride. When seated on the bike, your child’s feet should be firmly planted on the ground. The bike seat may appear too low and the bike too small; however, this technique enables movement security, engages proper core and postural stability, and increases confidence.
  • Braking System – Be sure to learn the difference between hand brakes vs. coaster brakes (using feet to backpedal). Both braking systems have pros and cons. Hand brakes are a personal favorite. They are more flexible to position, offer better control, but require adequate hand strength and coordination to manipulate. Coaster brakes (using your feet to pedal backward to brake) use an intuitive motor planning motion for children. When you pedal forward, you go; when pedaling backward, you stop. They are helpful for children who lack the hand strength skills to wrap and squeeze their hands around a hand brake; however, they provide awkward foot positioning and the constant tendency to backpedal.
  • Helmet – Safety, Safety, Safety! When handling a bike for any occasion (i.e., walking a bike, doing balance drills on a bike, or riding a bike), it should become an automatic habit to wear a helmet. Your child should be in charge of putting on and taking off their helmet independently. There is nothing more important than wearing a helmet that fits correctly with fasteners that can be easily manipulated. When choosing a helmet, be cognizant of the type of fastener/clasp it comes with and if your child has the fine motor skills to adjust it (this skill could take time to learn).If you are unsure if your child’s helmet is a good fit, any cycling store will be more than pleased to assist in finding your child the most appropriate size. 
  • Pedals – When learning to ride for the first time, the removal of pedals should be highly considered. It provides the opportunity to address balance, core, and postural stability for both younger and older children while also increasing movement security.
  • Training Bike – Which is best…balance bikes vs. training wheels? Balance bikes are light in weight and can be introduced to children at a much younger age than a pedal bike. They promote core strength and increase motor planning, sequencing, and balance training skills, making the transition from a balance bike to a two-wheel pedal bike more fluid and easier to manage. Training wheels promote ease in learning motor planning techniques to push on pedals while providing assisted balance. It’s important to note that removing the balance component can be disadvantageous when transitioning from training wheels to a two-wheel pedal bike.

Overall, the literature supports the observation that, for children with and without disabilities, learning to ride a bike is a popular activity that increases confidence, provides opportunities for shared recreation with families and peers, and promotes social inclusion (Dunford, Bannigan, Rathmell (2016).

Several of the many clinical diagnoses of children who can ride a bike follow here; however, this list is certainly not inclusive of the many other diagnoses that do not preclude children from bike riding:

  • ADHD
  • Anxiety
  • Autism Spectrum Disorder
  • Cerebral Palsy
  • Developmental Coordination Disorder
  • General learning disability
  • Hearing impairment
  • No diagnosis

The art of bike riding can be broken down into various steps, from learning how to use the kickstand to the act of pedaling. Each step deserves attention, because through repetition and practice, confidence is achieved.

If using these tips feels difficult or is not helping your child with the level of focus and skill they need to successfully achieve their goal to use a bike, we recommend reaching out to your occupational therapist or getting an occupational therapy evaluation. If in-person direct services continue to be a concern, biking riding skills can be offered via telehealth from the comfort of  your home. Jessica offers successful biking riding drills and adaptive home exercise plans through telehealth that address the skills required to learn to ride a bike. Contact NESCA’s Director of Clinical Services Julie Robinson, OT, to learn more at: jrobinson@nesca-newton.com.

 

References
Dunford, Bannigan, Rathmell (2016) Learning to ride a bike: Developing a therapeutic intervention. Children Young People & Families Occupational Therapy Journal 20(1) 10-18

 

About the Author

Jessica Hanna has over 10 years of pediatric OT experience in conducting assessments and providing treatment of children and adolescents with a broad range of challenges and disabilities, including autism spectrum disorders, sensory processing disorders, visual impairments, cerebral palsy, executive function deficits and developmental disorders of motor function. Prior to joining NESCA, Jessica trained and worked in a variety of settings, including inpatient and outpatient hospital settings, private practice, schools and homes. She has served on interdisciplinary treatment teams and worked closely with schools, medical staff and other service providers in coordinating care. In addition, Jessica provided occupational therapy services at Perkins School for the Blind and Spaulding Rehabilitation Hospital pediatric inpatient unit, where she conducted comprehensive evaluations and interventions for children with a broad range of presentations.

 

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.

 

The Benefits of Sensory-based Play

By | NESCA Notes 2021

By: Madelyn (Maddie) Girardi, OTD, OTR/L
Occupational Therapist, NESCA

The importance of play for child development

Play is considered an essential aspect of child development as it contributes to cognitive, physical, social and emotional well-being. As a pediatric occupational therapist, play is an integral part of my job. When children have opportunities to play, this allows them to build their creativity and imagination, resolve conflicts and learn self-advocacy skills. Through play, children develop new abilities that lead to enhanced confidence and resiliency, skills crucial for navigating day to day challenges. Play allows kids to practice decision-making skills, discover areas of interest and engage in passions. (Ginsburg, 2007).

 What is sensory-based play?

Sensory play can be described as any play activity that stimulates an individual’s sensory system. The sensory system includes touch (tactile), smell (olfactory), taste (gustatory), sight (visual), hearing (auditory), balance (vestibular) and movement (proprioception). Common examples include sensory bin or sandbox play, play with shaving cream, finger paint and/or food, use of a balance beam, ball pit, and/or swings, sound tubes, and so much more!

Why is sensory play beneficial?

While we know that play is a critical part of child development, incorporating a multi-sensory approach into play activities can be particularly beneficial. When activities are fun and meaningful – our senses are engaged – we learn best!

  • Promotes learning – children who engage multiple senses to accomplish a task are better able to remember and recall learned information.
  • Facilitates exploration, creativity and curiosity in children who may be seeking, or avoiding, certain types of stimuli.
  • Allows for strengthening of the brain pathways and connections that allow for efficient sensory integration.
  • Promotes self-regulation by allowing for interaction with different mediums that may be calming for the child (Educational Playcare, 2016).

What kinds of OT skills can be targeted through sensory play?

  • Sensory processing skills
  • Fine motor skills
  • Gross motor skills
  • Feeding skills
  • Body awareness
  • Motor planning
  • Visual perceptual skills
  • Communication and play skills
  • Self-regulation and coping skills

References:

Educational Playcare. (2016, October 27). Why Sensory Play is Important for Development.
https://www.educationalplaycare.com/blog/sensory-play-important-development/#:~:text=Sensory%20play%20includes%20any%20activity,%2C%20create%2C%20investigate%20and%20explore

Ginsburg, K. R. (2007). The importance of play in promoting healthy child development and
maintaining strong parent-child bonds. Pediatrics119(1), 182-191.

To learn more about Maddie Girardi, watch this video interview between NESCA Occupational Therapists Sophie Bellenis, OTD, OTR/L, and Maddie Girardi, OTD, OTR/L.

About the Author
Madelyn (Maddie) Girardi is a Licensed Occupational Therapist in Massachusetts with experience in both school-based and outpatient pediatric settings. Maddie received her undergraduate degree in Exercise Science/Kinesiology at The College of Charleston in South Carolina and  earned her Doctorate degree in Occupational Therapy from The MGH Institute of Health Professions in Boston.

Maddie is a passionate therapist with professional interest in working with young children with neurodevelopmental disorders, fine and gross motor delays and Autism Spectrum Disorder (ASD).

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.