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Lockdowns lasted so long, especially here in San Francisco. It’s been years without normal school routines or regular family outings.
And as everyone digs out from the pandemic experience, parents are beginning to wonder how to get development and education back on track — ASAP. If you’re concerned as a parent about the long-term impact, that’s justified. Although research is just beginning, we’re already seeing evidence of the impact of these pandemic years on child development. A recent study by McKinsey and Company found that children in K-5 were an average of 5 months behind in academics. We’re seeing a big push to “catch kids up“ on their education. But as a parent, you need to think beyond just academics. The truth is, catching kids up means backing up even further to include essential developmental skills that need to be addressed alongside academics. Development builds on itself. So it’s wrong to assume kids can move forward academically if foundational developmental skills aren’t fully established. Early development is based on interactions, experiences, and play. Lockdowns during the pandemic meant two things. First, families didn’t have the same access to activities and experiences. Second, all the juggling of work, school, and family life meant parents had less one-on-one time for interactions and play. As developmental specialists, we know kids missed the practice and experiences that are key for development across the board. We need to make sure we’re adjusting expectations to account for this. Otherwise, parents, teachers, and students will all grow frustrated when academics continue to be a challenge. Especially for kids who already struggle and feel farther behind peers developmentally during the pandemic. So today we’re going to share with you some basics of how the pandemic impacted the cognitive, speech, physical, and social-emotional development of kids. The good news is — kids are wired to learn! By understanding their development, you’ll be better prepared to guide your child through this time of readjustment. Cognitive Skills That Support Thinking and Learning From birth through the teenage years, the brain is busy building connections. These connections happen as a result of experiences, interactions, and practice. As connections grow, so does the ability for more complex thinking, language, and problem-solving. We’re already seeing that children born during the pandemic show delays in verbal and non-verbal cognitive skills. This is attributed to the emotional and situational environment during the early years. Babies just didn’t get the typical variety in experiences for interactions. And the impact on cognitive skills is seen in older kids too. They have had fewer play opportunities, fewer social interactions, increased stress, disrupted routines, and educational losses due to the pandemic. This translated to potential difficulty with:
As kids return to school, time needs to be spent introducing or re-introducing routine, organization, following directions and building up attention. Keeping in mind, a variety of fun, engaging activities promote brain development and key connections. Language Acquisition and Development Decreased social interactions and mask wear impacted language and communication development in young children. Speech and language development is important during the early years. This includes understanding words, making sounds (articulation), and expanding the number of words a child is able to use when communicating. Kids develop essential language skills through interactions with others. The more the better. A consequence of lockdowns is that babies and children missed language-rich experiences with teachers, extended family, and peers. Additionally, mask wear impacted language development because covering the mouth made it more difficult to hear, read lips, or read facial expressions. While these cues are important for all children, the impact of mask-wear was especially challenging for children with hearing loss, articulation challenges, and auditory processing challenges. Parents, educators, and healthcare professionals need to be more diligent in screening for speech delays and providing activities that encourage speech development. When in doubt, seek out a speech and language therapist for an in-depth evaluation. Developing the Strength and Coordination for Learning It’s easy to forget about the importance of coordination and strength for learning and schoolwork. Here’s what you need to consider. During the pandemic, kids spent more time in front of screens and less time in full-body play. However play — whether that’s outside, inside, or during PE — is an essential part of development for babies and school-age children. What does PE and playing outside have to do with learning? Motor skill development impacts a variety of other skills your child needs to learn:
Kids missed the time on the playground to build hand strength by swinging from the monkey bars. And preschool schoolwork was done on a computer instead of holding a crayon. So now you can’t hand your child a pencil and expect them to write. And you can’t send them to school and expect them to sit at a desk all day. So if your child is struggling with school work, consider how you might incorporate more physical play into their day whether that’s a park or coming up with activities at home. Social & Emotional Essentials Out of all the skills, the pandemic especially impacted the social and emotional skill development of children. In one study looking at parent concerns during the pandemic, parents reported they saw increased tantrums, anxiety, clinginess, boredom, and under-stimulation in their children. With the return to more group activities, therapists and teachers are now seeing the same social and emotional challenges as kids. Which makes sense. Social and emotional skills are honed during interactions with others. While parents play a key role in this, peer play is essential for giving kids practice in terms of interacting with others, responding to disappointment, and the give-and-take of relationships. During the pandemic, children mostly interacted with direct family members. Even attentive parents were faced with extra stress, responsibilities, and scheduling demands. Playdates were suspended and children talked through computer screens. This led to more difficulty using relationships to co-regulate. Additionally, our brain, through a process called neuroception, takes in cues from the environment to determine if we are safe or if we are in danger. If the brain determines the cues indicate danger, old survival circuits in the brain are activated to ensure quite simply that we survive through fight, flight, freeze, and even feigning death. Have you felt in survival mode for a better part of the last two years? Since March of 202o our brains have been flooded with cues of danger, which has led to chronic activation of our oldest survival systems. This explains the pervasive self regulation challenges we are seeing in adults and children alike. For some this feels like mobilization where our system is activated into fight and flight responses. This can lead to inattentiveness, irritability, rigidity, difficulty with transitions, and meltdowns. For others, this can lead to shut down responses. This can look like decreased energy, and motivation, disconnection from one's body, a feeling of being slowed down or a feeling of numbness. As kids return to normal activities, teaching self-regulation and social skills should be a priority. Especially since self-regulation has been identified as a key component of educational success. Parents can help children with this by providing guided activities to practice self-regulation. Additionally, for those where the old survival circuits seem to be chronically activated, there is a profoundly impactful therapeutic program available, The Safe and Sound Protocol, created by Stephen Porges, MD. This program works directly on supporting emotional regulation, grounding the body for safety, while also decreasing auditory sensitivity. Results from two clinical trials in children with Autism have demonstrated statistically significant improvements in emotional control, behavioral organization, hearing sensitivity and listening. You can also start resuming playdates and guide your child through steps of self-regulation or what it means to be a good friend. Social interactions can serve the purpose of providing opportunities for co-regulation, and restoring a sense of safety, community and belonging. These are not skills that happen overnight but take practice for kids to learn. Especially kids who already struggle emotionally or socially. Making Up for Lost Experiences We can’t expect kids to just go on as if nothing happened. We’ve got to help them catch up on these foundational skills but without adding unneeded stress or expectations. While it’s impossible to make up for what’s been missed, the great thing about kids is how much potential they have for learning and growth. We just need to be aware that they might need extra time to practice to regain skills that might have been put on hold. And if you’re concerned about your child’s development, get them seen and evaluated earlier rather than later. Our team of occupational and speech therapists is committed to providing a variety of services to help your child. We are also providers of the Safe and Sound Protocol. Christina Gallo, MS, OTR/L Pediatric Occupational Therapist, Infant Mental Health Specialist
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As school gets into gear, the reality of a school year online is really starting to hit. As a parent, you are facing the impossible job of balancing work, home, and education. Not to mention, you might be feeling a little underprepared for this new role based on the simple fact, you most likely don’t have any sort of background in education.
And if your child has learning differences or disability, you count on educational professionals to provide their expert guidance to build skills on a daily basis. Your child might not easily “catch-up” like other kids Quite honestly, many kids with learning challenges or attention problems can’t simply be set up with a computer and expected to navigate learning independently. There’s more to school than just the lessons from the teachers. School provides valuable childhood experiences for social interaction, movement, emotional regulation, and daily routine. But there are many things you CAN do to infuse these missing elements to your child’s at home learning experience. And, if nothing else, this year gives you the unique opportunity to customize elements of your child’s learning experience, taking in account your child specific needs and interests. And you’re not alone. Don’t forget you still have teachers and staff from school. Count on them to provide guidance for the curriculum. Your job is to fill in some of the other pieces: emotional regulation, structure, environment, movement, and social opportunities to give your child a great online school experience. So here are some ideas to get you started. Gather some hints, and adapt for your child. Use Your Regulation StrategiesThe traditional school day provides a lot of opportunities to practice self-regulation: taking turns, waiting in line, and dealing with frustration. Recognize your child’s need for the practice of self-regulation and look for ways you can provide support. Some Quick Pointers:
Use regulation strategies for yourself to maintain your own calm. You are taking on a big challenge. You are prone to have some big emotions along the way. It’s important to remember that by acknowledging your own feelings and experience, you are better able to support your child. So, find ways to take care of yourself. Whether that is going for a walk, doing some yoga, or carving out some alone time. Create an Environment for LearningNot everyone has the space in their home for a dedicated learning zone. And that’s ok. But find ways to set up a space for learning whether it's the kitchen table or a desk. Maybe it’s as simple as bringing certain supplies such as a pencil box or computer in a consistent place at the start of learning time. Try to find ways to limit distractions such as using headphones or making dividers so your child isn’t distracted by other things going on. Provide your child with fidgets that he can use to help him sustain attention, such as gum, a koosh ball, a stress ball, a rubber band. Did you know that 75% of the brain is water! Give your child a water bottle at the start of the day. Kids need water to think. And keep in mind, your child needs variety. So think of how you might use your space flexibly to allow for position changes and different views throughout the school day. Maybe your child watches their computer-based lessons at the table and then sits on a bean bag to do their reading. Visual SchedulesVisual schedules can be a powerful tool to keep everyone on track. They keep focus on the current tasks and show what’s coming next. Consider whether your child more easily understands words or images. Then, use pictures or words to show what needs to be done for the day. You can get as fancy as a chart purchased from online, pre-printed clip art or as informal as self-drawn pictures on a whiteboard. Then, let your child mark off items as they go through the day. It’s also helpful to add a visual timer where your child can see how long they are expected to play or work on their own. For younger children, timers with a visual element can help them understand how long something is supposed to last. For instance, Amazon carries visual timers that look like a kitchen timer but the red indicates how much time is left. The Learning Resource Time tracker offers a timer that goes from green to yellow, to red as time counts down. Even simple sand drop timers can show how much time is left for an activity. Develop a Healthy Routine Set up a realistic schedule that everyone can keep. Children do well with predictability but it’s also important to leave some room for flexibility based on emotional needs and the realities of daily life. Start off the week by spending some time planning.Then you have an overall grasp of what’s going on. From there you will know which tasks NEED to get done and where you can be flexible. One of the most powerful elements of a healthy schedule is a consistent sleep and wake up time. Set specific times for going to bed, waking up, and starting schoolwork. It might feel hard at the beginning but you will thank yourself later when this foundational schedule makes everything else run more smoothly. A healthy diet is also important as nutritious food can make a big difference in mood and energy. It's easy to fall into unhealthy eating patterns of snacking or convenience food when everyone is home so much of the time. High carbohydrate meals will lead to an insulin crash, and fatigue. Food dyes are associated with hyperactivity. Try to stick to simple whole foods. Think of creative ways to include your child in meal planning and meal prep. This will help you get the task completed and encourage some important skills. Cooking is not only an important life skill but also helps with regulation, following directions, math, and science. Movement Breaks Throughout the DayLittle bodies were made to move, not sit all the time. And when you think about it, movement is actually a big part of a typical school day. Teachers provide movement breaks between lessons, children go to recess, walk to different rooms for lunch or PE, or even walk across the room to get a book. Movement increases blood flow to the brain, helps improve attention, and decreases stress. So, if you child learns better when they aren’t expected to sit still all the time, this school year provide a great way to allow more movement. You might find it helpful to structure by planning in movement breaks about every 45 minutes. These could be getting up to clean, adding a stretch, or giving time for a planned movement-based activity. Maybe keep a tally sheet of how many laps your kiddo can do around the house! Think about how you can add a movement component to whatever you are learning about. If you’re learning about plants, take five minutes and pretend you are a plant growing. If you’re learning about numbers, make a list of movements (jump, flap arms, spin, clap) and roll a dice to find out how many you will do. And not everything needs to be a big event. You can even lead your child in a quick stretch or brief dance party. Everyone will feel more focused and ready to do the next task after moving around a little bit. Find Supports Outside the Home Seek out safe programming that will support your online schooling with your child. This is a marathon, not a sprint. Find things that will lift you up as a parent and will be meaningful for your child. It’s going to be especially important to find safe ways for social interaction or different scenery. Connect with other parents who are doing the same thing to get support and suggestions. You might even find some great outdoor locations to spend time together. And don’t forget about the support being offered at Child’s Play Therapy Services for families in the Bay Area. We grasp the importance of providing safe ways to get children the experiences and skill practice they continue to crave. We are committed to finding ways to support parents in the areas that might be missing with online schooling. From emotional regulation, educational therapy, outdoor groups, and ongoing therapy, we’re here during your journey in online schooling. Foster a Positive Attitude and Have Some Fun!Online school might not have been your plan for this year, but it can still be a positive experience. Celebrate your child’s wins along the way (and your own). Find your child’s favorite ways to learn and use it a lot! And most of all, give yourself room to be authentic – honoring the hard parts and cherishing the good. If nothing else, this year is sure to be memorable. We’d love to stay in touch and continue to provide you with supports during this year. Sign up for our email list where we will continue to provide parenting tips and ideas focused on supporting parents of children with disabilities and learning differences. Christina Gallo, MS OTR/L Child’s Play Therapy Services  It’s #TuesdayToolbox where we talk about one trick to keep in your toolbox to support your child!
Today’s Toolbox Trick is the Zones of Regulation. “The Zones” is a conceptual framework that helps students to gain skills in the area of self-regulation and self-control. The lessons and activities are designed to help the students recognize when they are in the different zones as well as learn how to use strategies to change or stay in the zone they are in. The Zones categorizes states of alertness and emotions into four colored zones (Blue, Green, Yellow, and Red) and prepares students to use strategies or tools to help them move between zones. It is a very effective, widely-used framework (both teachers and therapists use it!) that supports your child. The best way to start? Model it for your child. When you’re in traffic and feeling frustrated, let them know you’re in the Yellow Zone. After you yell at your kids, apologize to them and say you were in the Red Zone, which is why you went to your room to cool off so you could get back to Green. When you’re tired, tell them you’re feeling Blue Zone. Kids learn so much just by observing. So model it for them, and they will begin to conceptualize it! And stay tuned for a Zones of Regulation announcement coming in the next few days! If your child has dyslexia or other learning disability, educational therapy could be the answer you’ve been seeking and didn’t even know existed. You might be asking, “What’s educational therapy anyway?”
Think for a moment about the experience of being a child who struggles in school. Everyone else seems to just understand the material being taught. But for some reason, it’s just not that simple for you. Silly songs that seem funny to the other kids in the class, make no sense to you. You would probably start really disliking school, hide the fact that you don’t get it, or even just avoid those challenging school assignments altogether. How much of a difference would it make if someone just taught like your brain worked? Showed you how to make sense of what everyone is learning so that you could learn too. How much more enjoyable would school be? This is the experience of children with dyslexia. The power to learn how to learn is the reason educational therapy is such a valuable tool for children who learn and think differently. Never Heard of Educational Therapy? You’re Not Alone, Here’s the Basics. Educational therapy focuses on teaching skills for thinking and learning. Making it a powerful resource for children whose brains just work differently for one reason or another. Learning is actually a complex combination of small skills:
The list goes on! Here’s the thing: Schools don’t always have the same specialized knowledge in learning styles or the array of alternate ways to teach. They simply don’t have the same tools, time, or individualized services that can be provided by an educational therapist. And, educational therapy is more than traditional tutoring. Rather than just focusing on learning specific content, educational therapy focuses on teaching the process behind learning so that the skills can be used across school topics and grades. And ed therapy not just for children with identified learning disabilities. Many children just learn differently and benefit from educational therapy. For instance, children with:
The framework of educational therapy is especially valuable for children with dyslexia. So keep reading to better understand the tools of educational therapy through the lens of dyslexia. How does dyslexia impact learning ability? Dyslexia is a learning disability related to how information is processed in the brain. These are smart kids who just have brains that process information differently. Dyslexia impacts a variety of skills related to reading, writing, spelling, and math. At its most basic level, dyslexia makes it more difficult to process written words and numbers. When reading to themselves, those with dyslexia can have difficulty reading fluently and comprehending what is read. Basically, it’s hard to know what you are reading when it takes so much effort to figure out each word. Dyslexia can also impact other areas such as memory and the ability to deal with stress. Plus, challenges with learning can also lead to anxiety and frustration around reading and schoolwork. Much of the difficulty with learning is related to trouble with matching letters to sounds and being able to decode words. Decoding words is an early reading skill where unfamiliar words are sounded out. Children decode unknown words by recognizing the relationship between letters and sounds. Even before students learn to decode words, they need the skill of phonological awareness. This is a big word to describe a basic recognition of sounds, patterns, and syllables. Think of all the preschool songs where you clap out syllables, rhyme, or make up silly words by changing the sound of the word. But the good news is... children with dyslexia are smart and can learn, especially when given strategies that match the way their brain processes information. In fact, studies using brain scans have shown improvements in the brain areas related to dyslexia when using targeted teaching strategies1. So this is where educational therapy can really make a difference. By teaching correctly, children with dyslexia get a chance to learn in the way their brain works best. Let’s take a look at what that involves. How does educational therapy help dyslexia? Samantha Martinez, Educational Therapist at Child’s Play Therapy Services in East Bay, CA describes some of the methods she uses when working with children with dyslexia. She focuses on using Linda Mood-Bell’s program Seeing Stars to work on skills related to hearing and seeing sounds in words. Multi-Sensory Learning Using the different senses to learn, children get to see, touch, smell, hear, and move to learn about a concept. According to Martinez, “Multi-sensory learning helps to bring the words to life to help children with dyslexia learn in a different way. These methods focus less on the printed text and more on finding other methods to learn the patterns and parts of words.” Things like:
It’s a way of learning that focuses on physical movement and other forms of visual processing to help your child with dyslexia learn. Mindfulness This skill is focusing on the present by using breathing strategies and calming the mind and body. According to Martinez, “I start each session working on mindfulness. It’s important to start with mindfulness to prepare your child for learning and because it’s an easier skill to learn when you’re not stressed.” This is a powerful tool for children with dyslexia because it can get them recentered and able to work through the tough spots. Because having a learning disability can be frustrating, children with learning disabilities are more likely to deal with anxiety both in childhood and throughout their life. Use of Games Children love learning through games. Makes sense, right? It’s just more fun! But there is a very practical element to using games when working with children with dyslexia. It gives great opportunities to practice sequencing and processing information visually. It also gets the brain warmed up for processing visual information faster and more automatically. Educational Therapy Celebrates the Unique Way Each Child Learns In the end, each child with dyslexia learns in their own way. Educational therapy offers the opportunity to trial different ways of learning – finding what works best for your child. And then provides practice to give your child the confidence to use these tools in the classroom, across subjects and for years to come. And, this isn’t only true for children with dyslexia. The tools for learning provided by educational therapy can help children with many different types of learning and organization challenges. Wondering if educational therapy might be right for your child? Call to schedule a free 15-minute consult with Samantha Martinez at Child’s Play Therapy Services in the Bay Area, CA. References: Huber, E., Donnelly, P.M., Rokem, A. et al. Rapid and widespread white matter plasticity during an intensive reading intervention. Nat Commun 9, 2260 (2018). https://doi.org/10.1038/s41467-018-04627-5 What is Educational Therapy? What is Dyslexia? Understanding and Helping Your Child Adapt in the Time of COVID. Christina Gallo, MS, OTR/L6/8/2020  Miss Irene Take a minute to imagine you’re a kid during this strange time. From the perspective of a child, you might think: I suddenly stopped going to school and all my activities changed. My parents started helping me with school and I got to stay home and do lots of fun activities. But, I’m still a little confused...
Understanding Fear and Security During Change Parenting has always been challenging but it seems a little extra complex now. How do you help your children navigate these changes? This uncertainty. This fear. It’s a big undertaking. But, amazing parents take this encouragement: There are many ways to build safety and security – even in times of change. Children thrive when they feel safe and secure. When they know boundaries and expectations. This provides a foundation for exploration and creativity. Many parents have done an outstanding job of supporting their children this year by following flexible routines, creating space for emotion, and finding fun things to do at home. Children will have memories of spending days in pajamas, building forts, and spending more time as a family. But the truth is, COVID has introduced a new situation of uncertainty. Routines changed suddenly and drastically. And even with the ending of shelter in place restrictions, things are still different. Social distancing and mask-wearing represent changes to accepted social norms to allow people to function safely in a world where Coronavirus still exists. It can feel like a big task to explain social distancing and COVID with your children – without causing fear. So keep reading to learn some tips and how to help your child adjust to current change. And, how the staff at Child’s Play Therapy Services will provide support. Tools for Responsive Parenting Following Shelter in Place Change doesn’t need to be bad or scary. You just need to take steps to help your children process and adjust. Certainly, school in the fall will look different. Taking small steps now will ultimately help prepare children and reduce overwhelm from altered routines. Children with Difficulty Seeing People Wearing Face Masks Some children might have a difficult time seeing people wearing masks for a number of reasons:
To work on seeing people wearing masks, try putting a mask on in front of your child so they see you wearing one. And even try to make it a fun game. Before going out, Talk about how people will be wearing face masks. And explain doing this helps everyone stay healthy. You might also want to discuss that different people make different decisions in case your child sees someone not wearing a mask. You can also start to show your child pictures or videos of people wearing masks so they can start to see it as a normal thing. Here are some pictures of the staff at Child’s Play Therapy in face masks. Show your child and help them prepare for their next therapy session We’re wearing face masks during all our clinic sessions for safety, but it also provides a good chance to practice seeing a familiar person with a mask on. Plus, when staff interacts with children in the clinic, we have the time and training to talk children through the experience. Children Who Won’t Wear Face Masks Many children refuse to wear face masks because they’re uncomfortable. Adults can use reason to overcome discomfort. However, children are quick to refuse something that feels uncomfortable, especially children with underlying sensory challenges. To work on wearing face mask:
The world is going to be full of people wearing masks now so we feel this is an important functional skill to start incorporating. The more we practice, the more we get used to it. We aren’t requiring children younger than age 11 to wear face masks in the clinic. But, we will be available to troubleshoot with families regarding any issues surrounding face masks. Whether that is helping your child adjust to wearing a face mask, communication issues that result from mask wear, or finding adaptive options for shielding the face. Hand washing for Children Hand washing has always been an important daily living skill – but it's even more important now. Many kids, especially those with sensory or developmental differences, have difficulty with hand washing. To work on this at home:
Pediatric occupational therapy is a great way to work on the skill of hand washing and applying it to a variety of settings. Each therapy session starts with hand washing so there will be plenty of chances to practice. Social Distancing Children love to play and hug and poke and giggle. It is a normal part of childhood. Now, personal boundaries aren’t just about manners but also part of keeping everyone healthy. The amount of distance required around people presents a big change that is hard for children to understand. Pediatric occupational therapy can help kids on an emotional level so they understand these changes and have a chance to practice in a safe context. We will give opportunities to practice social skills with social distancing guidelines in mind. Processing Safety and Change You can work on this at home. Research has shown that talking with parents plays an important part in reducing fear in uncertain situations1. You can talk about:
A part of pediatric occupational therapy is talking through safety and security. It is fitting to talk about and practice change in a therapy session. Research has shown that using narratives to talk about upsetting events soon after the incident can help improve coping in children. Sometimes children talk more when moving or participating in sensory play. And overall, helping children process trauma and feel safe helps grow skills and support emotional well-being. Children Are Ultimately Adaptable and Will Form Positive Memories Children are amazingly resilient. They adjust to change all the time. Sometimes adults benefit from learning about adjusting to change from the young ones! Children will likely remember this time – because it’s been a pretty memorable event. With parents not going to work, school's closing, and everyone needing to wear masks. But, amidst all the worry and unknowns, it can also be a time of fun memories and recognition of your family bonding through the changes. By providing a stable base for your children, you support their ability to process change. Strive to help them build a story around what has happened, as forming a cohesive narrative provides a valuable tool for helping your children make sense of and process traumatic events. The staff at Child’s Play Therapy Services is ready to help your child adjust to change and continue towards their goals. Call for an appointment today! Resources:
 Christina Gallo, MS, OTR/L Executive Director Staying Regulated amidst an uncertain world. Tools for regulation. Post by Irene Lestari, MS, OTR/L5/14/2020 Sensory tools for kids
Amidst the COVID-19 outbreak, our lives have been altered in many different ways. Disruptions of daily life and routines can cause our body undue stress. Stressful experiences or the presence of sustained stresses, such as during these unprecedented times, can wreak havoc on the nervous system. Amid school and extracurricular activities closure, children are deprived of their needs for sensory input. Rather, they are stuck at home, with less than optimal sensory stimulation they were used to prior to this pandemic. Children react to stress differently than adults. They tend to somatocize their stress within their body and give meaning to emotions and feelings through their bodily sensations. It makes sense then to utilize their body and senses as vessels to alleviate any accumulating stress or discord in their body. As such, their bodies and senses can be utilized to mitigate the effect of stress which subsequently fine-tune and regulate the nervous system. Engaging in sensory experiences can also activate and strengthen the vagal nerve by calming the autonomic nervous system through stimulation of the parasympathetic (calming) nervous system. To glean upon the intricate interplay between sensory input and our capacity to regulate stress, it is useful to have some understanding of what sensory processing is and how our senses function. Sensory processing is the ability to take in sensory information, process that information, and then produce an output response to function efficiently and effectively in the environment. Efficient sensory processing allows the central nervous system to regulate such things as attention and activity level by enabling one to attend to salient stimuli, filter out irrelevant stimuli, and modify the amount of stimulation one is exposed to. Stress can have a direct impact on sensory processing capacity. During stressful situations, your child’s ability to process sensory input can be different from when they are in a calm/restful state. Deep tactile input, deep pressures as well as proprioceptive input are especially pivotal to restore balance to the nervous system. Deep breaths, humming, and singing is known to stimulate the vagus system, which can improve arousal state. We all know the five basic senses: sight, smell, hearing, touch, and taste. These five systems are important to everyday well-being in everyone, two other senses that are less talked about, but are just as important. These are the vestibular and proprioceptive systems. The tactile or touch (skin) sensory system has many vital functions, including providing us with the ability to know what an object is without looking (tactile discrimination) and identifying temperature and pain. Deep tactile input is calming and organizing for the body. It releases dopamine, which combats the effect of adrenaline and cortisol that is released when the child is in a high stress/fight or flight state. Movement or the vestibular system consists of parts of the inner ear and related central nervous system structures that perceive and interpret changes in head position. It automatically coordinates movements of one's eyes, head, and body. Activities that provide vestibular input are activities that changes the position of the head in relationship to gravity. The vestibular system is the first sensory system to develop and is therefore the foundation for all other sensory systems. For children that are over-reactive to vestibular input, linear vestibular activation is the first type of movement provided as it is the least intense type of movement. It is important to follow all vestibular input with heavy work as this can help reduce any dysregulation that may occur as a result of vestibular input. The proprioceptive system provides information related to the muscular and skeletal systems and, therefore, the position of one's body. Proprioceptive input, or "heavy work" activities, are activities that challenge a child to move against resistance. These include pushing, pulling, climbing, carrying, log rolling, etc. Proprioceptive input provides organizing stimuli to the nervous system which can help with motor planning and body awareness, improve attention, and increase muscle tone. This calming and organizing input can also combat an aroused state. The regulating effects of 15 minutes of proprioceptive input can lasts 2- 4 hours depending on the child and the intensity of the input. Vision consists of both the motor function of the eye as well as perception of visual information. It is also a protective sense which offers information about what is happening around us. The auditory system consists of hearing, speech, and language, the child's response to sound, and their ability to perceive the spoken word and follow directions. Included in this blog are some simple sensory tools you can try to help regulate and decrease stress to the child’s nervous system. It is crucial to engage in multiple sensory systems' activities every 3 hours to notice their positive effects on the child's nervous system. Finding the most appropriate sensory experience at the right amount is the key. Examples of selected daily activities are included at the end of this blog. Sensory regulation tools Tactile/Touch
Visual schedule as organization · Have a visual schedule. Visual schedules are an effective way to help children manage challenges with focus, task execution and transitions. A visual schedule would be helpful for the child to outline daily events and also to break down daily routines such as the morning and bedtime routines. A visual schedule can be an important component in regulation so the child can know what is expected and when, it brings a sense of order and predictability into the home. A good companion to a visual schedule is a tool to track time. · Provides a daily schedule to organize the child’s day. Start with one part of the day and make a list of 3-5 tasks that the child is required to do. · Adding pictures to be more specific about the task can improve accuracy and follow through. · Different tools for executive function tasks can be found here: http://efpractice.com/shop Other strategies for the home · Try to schedule calming activities in between more demanding activities to maintain the nervous system at a calm state. · Prepare auditory and visual materials ahead of time to assist in transitions. Timers, clocks with alarms, watches with a timer and concrete transitional objects may be helpful during transitions. · Modeling self-care and attunement to your own needs for sensory activities. · Keep a “sensory backpack” to use during “sensory emergency”. Fill the backpack with items such as massagers, different essential oils, headphones and regulating music, a soft weighted toy animal with different textures, a book with different textures, play dough, pipe cleaners, chewy toys, and pop beads. · Have an area in a house designated for a calming, quiet sensory oasis. Have it be a darker corner in the house filled with tactile activities (such as water beads, kinetic sand, theraputty, and weighted blanket). · Provide daily access to dry sensory play materials (make a bin filled with different tactile items). In cooperating sensory tools into self-care routine Eating:
· Listen to calm music (ex: light classical music, piano covers of Disney songs) · Play with a fidget · Eat crunchy snacks · Sit with weighted blanket and/or weighted toy · Carry a Sensory backpack during trips: massager, a soft toy animal with different textures, balloon, scratchy stickers, lavender, lemon and minty smell, silly putty or play dough, headphone and music, fidget stuffs: rubber coiled key chains, pipe cleaners, wiki sticks, chewy toys, stretchy band, coil shoe string, plastic pop bead, and koosh ball) Example of daily sensory activities Monday
- Animal walks
Tuesday
Wednesday
Thursday
Friday
- A magic carpet ride - Push something heavy - Play in the water or swimming or extended bath
Saturday
Sunday Outdoor play! References Moore, K.M (2008). The Sensory Connection. Self-regulation workbook. Learning to use sensory activities to manage stress, anxiety and emotional crisis. Franconia, NH: The Sensory Connection Program. Yack, E., Aquilla, P., Sutton, S (2015). Building bridges through sensory integration (3rd edition). Arlington, TX: Sensory world.  Everything is different now. The way we work, the way we interact, the way we school our children, the way we deliver and receive health care services…it’s all changing. And these changes are not easy. So much on the internet is telling us, it’s a blessing! Slow down and enjoy! But what about our responsibilities? We can’t just drop those because the world told us we can’t go outside. We still need to pay our mortgages, we still need to buy groceries, our children still need to learn, and some children still have therapy goals. I’ve talked to many parents right now who are trying not to panic, but are worried about progress. You’ve been working so hard for so many years, spent so much time and money, and now it all comes to a screeching halt.
But did it? Yes, clinics and schools are closed. Therapy services are delivered through video instead of hands-on treatment. But really, what are our therapy goals? Sure, some children have postural goals, some children have handwriting goals, some children have social-emotional goals, some children have sensory integration goals. However, when we zoom out and look at all those goals, they have one major thing in common. It’s “allow my child to participate in their roles in a way that is joyful and engaging.” And what is a child’s role? It’s the role of a son or daughter, the role of a brother or sister, the role of a student, the role of a friend. So maybe, this time gives us a chance to support our child’s roles in a way that we didn’t have before. Talk to your child’s OT to make sure you understand the underlying foundational skills that your child struggles with, so you can allow your child to participate in your family life in a way that supports their goals and gives them a purposeful role. Keep those telehealth appointments, and use that time to really feel empowered. Does that sound overwhelming? It might, but it should also feel freeing. Take a deep breath and know you can do this. Set yourself up for success. Be well fed and hydrated yourself, and expect that things will be different. But with no extra-curricular activities to get to, does it really matter if something takes a little longer? I’m going to say no. Use Everyday Activities We can use everyday activities to support their goals. When the main goal for therapy is participation in life, then why wouldn’t we use everyday activities? We can use these activities to target underlying skill deficits. But we need to be mindful about how hard some of these tasks can be! If you know what’s hard for your child, you can help support your child in doing them. If your child has trouble with visual scanning, guide them to look across the entire room when cleaning her toys. If your child has postural instability, get on the floor with them and help them shift their weight while he’s Swiffering. If your child has sequencing challenges, break down a cooking task to two or three steps at a time. If your child struggles with fine motor skills, let her peel her own banana or orange. This is where a conversation with your OT comes in. We can help guide you in how to help your child so that they can participate. Use telehealth sessions to learn how to support your child. Let’s break down a few common household activities that can’t be put on hold just because everything else in the world stopped. Speaking as a parent, the hardest part about this is recognizing that things will be a little different. It will take longer. It will make a bigger mess. It will not be the way we usually do it. But take a deep breath in, and a long exhale out. Realize that the end goal of each activity is not to complete the activity perfectly. The goal is to allow your child to participate in the family in a way that is meaningful to them.
Now is the time to really think about your child within the context of the family. It’s time to slow down, and participate in daily life with them. It’s time to observe them without being dictated by busy schedules. Allow them to participate, and be mindful about how they participate. Know their struggles, but identify their strengths. Recognize and verbalize their value within your family dynamic. And let’s use this time to support their goal: the bigger, overarching goal of creating meaning in everyday life, so that when this is all over, they can go out into the world and flourish. Hello Child’s Play Families,
We are working on compiling a place for resources to help support you and your families through these unprecedented times which we will attempt to update periodically. However, these are merely just suggestions. We in no way want this to overwhelm. At a time like this the most important thing is to practice self-care, hugs, connect with your kids, play, go outside, and remember to breathe!
A. Examples of Daily Schedules: 1. OT Specific Activities: https://creativehealthllc.com/wp-content/uploads/2020/03/COVID-Calendar-OT-Activities.pdf?fbclid=IwAR0BGngvdLXuTvWsfUYagbZejLpIZB89BpCItUgQHCJC339CherCc6eoBI 2. https://mommyhood101.com/daily-schedule-for-kids B. Sensory Strategies 1. https://www.spdstar.org/node/1485 C. Gross Motor/Play Ideas: 1. Movement break for Kids https://family.gonoodle.com/ 2. Cosmic Kids Yoga https://www.youtube.com/user/CosmicKidsYoga 3. 87 Energy Busting Games and Activities for Kids (Because Cabin Fever is No Joke) https://whatmomslove.com/kids/active-indoor-games-activities-for-kids-to-burn-energy/
D. Calming/ Stress Relief for the Caregiver: 1. https://www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html 2. https://www.nytimes.com/2020/03/18/parenting/parents-need-stress-relief-too.html E. Academic or Other Resources:
Credit: 1. Brij, Maliya OTD, OT From Sarah Guy, COTA!!
Here are two great little routines that I found from Raising an Extraordinary Person. Roxy who is 8) and I had so much fun doing them today! For some kids 45 seconds might be a bit long for some of the activities so you can adjust accordingly. It’s a good idea to do movement activities such as these at least twice a day, once in the morning and once in the afternoon. https://hes-extraordinary.com/morning-workout-for-kids Here is another good one. https://hes-extraordinary.com/improve-emotional-regulation-just-7-minutes-per-day For kids who are sensory seekers (kids who are on the move all the time) intuitively we typically try to calm them down. However, it’s important to remember that these kids need more activity, not less, to satisfy their sensory needs. Activities should include a lot of vestibular and proprioceptive input. Here are some ideas: *Note: it is a good idea to include ways to engage their brain while doing these activities below and provide lots of changes to head position and stops and starts. Simply jumping on a trampoline may actually wind them up rather than regulate them. So for example, you could have your kiddo jump on the trampoline while counting by 2s until 30, then crash onto couch cushions or a mattress on the floor, then bear walk to grab a stuffed animal, and then back to the trampoline for more jumping (this time counting by 5s). Vestibular input for fast, intense, arrhythmic swinging, jumping, bouncing, or rolling such as: Swinging on a swing from a single point Log rolling Forward rolls Trampoline jumps Bouncing on a therapy ball Upside down bowling (with head down and rolling ball between legs to target) Sliding down the slide head first Scooter rides Yoga moves that get the head upside down. Proprioceptive input of pushing, pulling, climbing etc. Get and give blanket rides pulling each other around the room on a blanket Carry books, groceries, or the like Climb up the slide Tug of war Wall pushes Yoga Push ups Sit ups Jumping Jacks Crawl or run over couch cushions on the the ground Jump and crash onto the couch cushions Jumping on a trampoline Mopping the floor Washing windows Scrubbing...well anything! Dusting The chores idea is limitless! After doing some of the above then you can give your kiddo some calming deep pressure input such as: A massage Rolling a therapy ball over them Squish them between couch cushions Pillow fight Brushing with joint compressions For kiddos that are more on the over-responsive type or anxious about movement activities it is best to start with deep pressure input such as mentioned above. Also it is important to keep vestibular activity slower, linear (back and forth), rhythmic, and predictable such as swinging on a swing from 2 points or rocking on a rocking chair. After that some proprioceptive activity is a good idea. |
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