by Phillip Kindschi | Sep 4, 2013 | Occupational Therapy, Physical Therapy, Speech Therapy
Your child’s care and progress is our number one priority at TherapyWorks. We have all heard the phrase “it takes a village”, well it truly does to care for a child with special needs. Do you know who is or should be on your child’s team? For example, did you know that a child with cerebral palsy should be seen by an orthopedic doctor every 6 months to year for hip and spine x-rays because they are at greater risk for dysplasia? Many times families are referred to various specialists without fully understanding what that person’s role is in their child’s care. The following is a list of the most common specialist that may be apart of your child’s team.
Therapist: Occupational Therapist, Physical Therapist, Speech Language Therapist and provide therapeutic services
Orthopedic Physician: Specializes in treating conditions and injuries involving bones and connective tissue, including tendons and ligaments
Neurologist: Specializes in study, diagnosis and treatment of injury and disease of nervous system. These include brain, spinal cord, muscles and nerves throughout body.
Pediatrician: Specializes in the medical care of infants, children, and adolescents The age limit usually ranges from birth up to 18 years.
Developmental Pediatrician: Developmental pediatricians focus on developmental, behavioral and learning
issues from infancy through young adulthood
Geneticist: Evaluate, diagnose and manage patients with heredity conditions or congenital malformations
Vision Therapist: Also known as vision training. This treatment is used to improve vision skills such as eye movement
control, eye coordination and teamwork. This is performed under supervision of optometrist, or orthoptist
ENT: An ear, nose and throat doctor specializes in diagnosis and treatment of disorders of the ear, nose, sinuses, throat, face and neck.
Psychologist: This specialist evaluates, diagnoses, treats, and studies behavior and mental processes. Clinical psychologists and school psychologists work with patients in a variety of therapeutic contexts
Psychiatrist: Psychiatrists are medical doctors who must evaluate patients to determine whether or not their symptoms are the result of a medical illness, a combination of medical and mental, or a strictly mental one
If you are unsure if your child should be seeing one of these specialist please consult with your therapist and pediatrician for a recommendation. It is very important that if your child is seeing one of these specialists that you please inform your therapist so that they can collaborate and be informed of and changes in plan of care.
by Phillip Kindschi | Jul 31, 2013 | Occupational Therapy
What is “Crossing Midline”?
Imagine a line dividing your body into right and left sides. Crossing Midline includes any activity that requires one side to cross into the other side. Imagine using both hands to put on your shoes and socks, brushing your teeth, using your tongue to manipulate food from one side of your mouth to the other, combing your hair, reading, writing, etc.
Why is this important for brain development?
Crossing midline all starts with crawling, which typically develops around age 7-11 months. Crawling is a very important developmental milestone. For many children, especially those with Autism, Dyspraxia (motor in-coordination), or Dyslexia, they may have “skipped” the crawling stage all together. Crawling is important because it works on upper and lower body dissociation, trunk/core rotation, weight bearing/weight shifting, reciprocal movement patterns, and dynamic movement transitions (ie.: quadruped to side sit, quadruped to ½ kneel, etc.). This is also a precursor for crossing midline which is necessary for the brain to communicate across the corpus collosum, the thick band of nerve fibers which connects the two brain hemispheres. This is required for higher level skills such as reading and writing. In fact, research has shown that children with dyslexia have smaller, less developed, corpus collosums.
Symptoms:
Children who do not cross midline often do not develop hand dominance which should be determined by age 5. Children who do not cross midline often show symptoms including:
- poor fine motor control (immature pencil grasp, poor manipulation skills)
- poor bilateral coordination (catching a ball, cutting skills)
- poor upper/lower body coordination (jumping jacks, riding a bike)
- poor right/left discrimination
- becoming “stuck” in mid-reach and having to switch hands
Activities for home:
*Tip: For young children you may need to use stickers to match/touch (i.e.: red for right hand/left knee) or use a piece of tape to divide the body in half
Gross Motor:
- Cross crawls (bring your opposite hand, or elbow, to your opposite knee) x20-30
- Behind-the-back cross crawls (touch your right hand to your left food behind your back so the child uses body awareness instead of vision!)
- Sit criss-cross and throw a ball to a target on the opposite side of the body (look for core rotation). Gradually increase the angle of the throw.
- Sit back-to-back (or for a group sit in a circle) and use trunk rotation to turn and pass an object (i.e.: ball). Remember to go 10-20x both directions!
- Simon Says or Hokey Pokey for right/left discrimination i.e.: “Touch your left ear with your right hand”
Fine Motor:
- Hand games (Patty-cake, etc.)
- Bongo drums (may have to use stickers to match opposite hand to opposite drum)
- Restrict one hand, and use opposite hand to reach/grasp a variety of items, remember to reverse so both preferred and non-preferred hands are used. (i.e.: Memory game cards, puzzle pieces, anything!)
- Place x10 pennies or playing cards as a semi-circle across the table. Make sure child is exactly in the middle of the table and does not lean over to compensate. Use one hand to flip each item over than the opposite hand to flip over again.
- “Infinity 8” – draw a horizontal 8 on the table, or better yet on a vertical surface such as a mirror or easel. Position the child exactly in the middle then trace the 8 with both hands together, then right, then left. Do 5-10 loops per hand. This can be especially fun with shaving cream and toy cars to make a “racetrack” on your table or window J
- Wand play: Make a “Racetrack” (figure 8), “Ferris Wheel” circles (in front), and “Helicopter” blades (overhead) with bubble wands, streamers, scarves, ribbons, etc.
Great pictures and additional activities:
by Phillip Kindschi | Jun 3, 2013 | Occupational Therapy
It’s summer time and time to play, but why not continue the learning as well with some OT fun. As kids play in the summer and focus on all the fun activities, there are ways to incorporate and maintain the skills they have learned throughout the year while learning through play. Here are some ideas to do this summer to incorporate some fun OT skills!
Fine Motor Skills and Handwriting
Keep a summer journal- have them write out one entry per day of what they did during that day. If working on reading skills, have them read aloud at the end of the week to remember all the fun things they did throughout the week! If they are not writing sentences yet, have your child draw a picture of their favorite thing that happened that day. This works on pre-writing shapes and drawing that is necessary for letter formation and will help improve visual motor skills as well.- Make cereal necklaces on stretchy string so that they can wear throughout the day for a little snack. Lacing cereal such as cheerios or fruit loops works on grasping small objects as well using both hands to lace onto the string.
- Coloring and painting pictures with water colors is always a great way to improve grasp on different writing utensils. Also, using a vertical surface such as taping paper on a window or refrigerator, will promote improved grasp and proper hand positioning for handwriting. This is also great to pack for those summer vacations!
Visual-Motor/Perception Skills
- Matching letter pieces then to written form with magnetic letters on the refrigerator. If you need to take a road trip then bring along a cookie sheet that can be used as a table. This helps practice letter identification, sequencing, name, and spelling.
- Complete various puzzles (interlocking or insert). You can make it more challenging by hiding it in a rice or bean bin and have them locate pieces. You can also hide them in various parts of the house and make it into a scavenger hunt by having them follow verbal or written directions. This works on listening and sequencing skills.
- Make a maze with sidewalk chalk on the driveway and have them follow with their bike or scooter, making sure they stay within the path and working on problem-solving to find the end.
Sensory Play
- Swimming and various pool activities are a great way to get multi-sensory input with kids. Games such as basketball, searching for dive sticks underwater, playing “red light, green light” working on motor coordination and modulation allowing them to control their bodies when stopping or going.
- Messy Twister- it’s the regular Twister game board with a twist!! Place matching paint on the colored spots and play as directions instruct, except a lot messier!! This is suggested to play outside…unless you want multi-colored carpet!! Great for motor planning, right/left discrimination, and tactile sensory input.
- Make your own slime by taking 1 cup clear liquid glue + 1 cup of liquid starch. Separate into small bowls and add food coloring. Then squish, stretch, and play with slime! Very good tactile sensory play.
by Phillip Kindschi | May 1, 2013 | Occupational Therapy
Visual tracking and perception are important for many daily activities such as reading, gross motor skills such as playing catch, writing, board games and more. Poor visual skills also impact attention. If a child is unable to process visual input correctly they may become frustrated and shut down when trying to complete task or will be unable to attend to task. Poor visual processing skills are often times linked to ADD/ADHD symptoms. Many times parents will report that visual acuity is good, which is what there optometrist told them. What many parents don’t understand is that visual acuity and perception are two different things. Visual acuity is the ability to see clearly and sharply visual perception is how we process and interpret what we see for a functional outcome (“Visual Perception”, 2013).
Many families come to occupational therapy for concerns with poor reading skills, dyslexia concerns, poor attention, behaviors and poor coordination. Vision is a basic sense that we all rely on daily to complete just about any task we do. We need to be able to visually track, accurately localize and focus on an object, and use binocular vision to be able to read, write and move around and participate within our environment. As an occupational therapist we are trained in the basics of vision and can work with a child on these skills, although it is also recommended to consult with a vision therapist.
Megan is a 9 year-old girl that I have been working with for 7 months. When I first started working with Megan she had very poor reading skills as well as poor gross motor coordination, handwriting and poor attention to task. Megan has been working on various visual exercises, such as left/right discrimination, visual memory skills, tracking, and her ability to better quickly locate and focus in on an object. As she has been practicing to improve these skills in the clinic and at home with her parents she has shown very nice improvements in her ability to read, write and her gross motor skills such as catching a ball. Megan has improved her reading skills since starting OT from Kindergarten level to 2nd grade level! When playing games with her peers now she can better attend to the game, increased ability to read her own cards, and improved her ability move and sequence piece when playing board games. Megan’s demonstrated better visual spatial awareness, which has helped increase her gross motor skills. Her visual processing skills have played an important roll in improving her overall skills to help her better participate in many activities and improve her self confidence.
Visual perception. (2013, April 10). In Wikipedia, The Free Encyclopedia.
Retrieved 17:53, April 15, 2013, from http://en.wikipedia.org/w/index.php?title=Visual_perception&oldid=549759866
by Phillip Kindschi | Apr 29, 2013 | Occupational Therapy
At TherapyWorks, we “work wonders in children’s lives” with physical therapy, speech therapy and occupational therapy, along with diet and nutrition therapy. And while most people know about physical therapy and speech therapy and nutrition, a lot of people aren’t quite sure what occupational therapy is.
So, just what is Occupational Therapy???
Occupation can be defined as the way we occupy our time. It includes the daily activities of:
Self-Care: sleeping, eating, grooming, dressing, and toileting
Work: effort that is exerted to do or make something, or perform a task
Leisure: free, unoccupied time where you choose to do something enjoyable (i.e., hobby, tv, sports, socializing, read, listen to music, travel, etc.)
Occupation is how we spend our time; whether paid or unpaid, restful or fun, obligation or choice. It is that which fulfills us, gives us purpose, and allows us to interact with, be productive, and function in the world around us to the best of our ability.
If, at any point in our lives from birth to old age, an injury or disability prevents us from effectively or independently functioning in one or more “occupational” areas, then it is the job of the Occupational Therapist to provide treatment. OT helps you learn or regain function, maintain skills, or make accommodations for deficits you may experience. In other words, so that you may live life to the fullest!
Since many people have never heard of OT, they think it is a relatively new profession. Actually it began in the late 1700’s but was not formally named occupational therapy until 1917. In the 1700’s the mentally ill were locked away in insane asylums and treated like prisoners. Phillipe Pinel, a French physician, and William Tuke, an English Quaker, started to challenge this treatment and developed new beliefs about how to improve the lives of the mentally ill. Phillipe Pinel began what he called “Moral Treatment and Occupation”, defining occupation as “man’s goal-directed use of time, energy, interests and attention”. He advocated for treatment based on purposeful daily activities. He used literature, music, physical exercise, and work as a way to “heal” emotional stress and improve the patient’s ability to perform activities of daily living (ADL’s).Tuke’s basic premise, called “moral treatment” was based on the principles of “consideration and kindness”. Tuke felt occupations, religion and purposeful activities should be used to improve function and minimize the symptoms of mental illness. He encouraged patients to participate in a variety of employment or “amusements” (leisure activities) that they enjoyed.
These ideas spread to the US and from 1840-60 many American hospitals began to use these new treatments. Arts and crafts activities were used for both relaxation and feelings of being productive. Many of these concepts were nearly lost during the upheaval of the Civil War. In the late 1890’s, nurse Susan Tracy successfully brought back the use of “occupation” with the mentally ill. She began to specialize in this field and started educating student nurses on the therapeutic use of activities as part of treatment. Tracy coined the term “Occupational Nurse” and called the training “occupation work”.
On March 15, 1917 Susan Tracy, Eleanor Clark Slagle of Johns Hopkins Psychiatric Clinic and 5 others formed the National Society for the Promotion of Occupational Therapy (NSPOT), which was later changed to the American Occupational Therapy Association (AOTA). The founders were dedicated to building a role for occupational therapy in the health care community that incorporated treating mind, body and spirit.
During and after World War I over 5,000 reconstruction aides were hired to provide occupational therapy to the war’s wounded. In the 1920-30’s training programs were established at universities and OT expanded to include health care and hospital based medical treatment. Thousands of returning soldiers with physical injuries and mental problems from WWII, Korea and Vietnam received occupational therapy as part of the “Rehabilitation Movement”. During the 1950-60”s the practice of OT expanded and therapists specialized, providing treatment for the mentally ill in institutions, physically disabled adults and children with cerebral palsy and developmental disabilities. Medicare covered OT services starting in 1965 and in 1975 The Education of the Handicapped Act was passed and Occupational Therapy was included in the public schools as a “Related Service”.
Today Occupational Therapists continue to use purposeful activities. Children occupy their time in play, learning and have a wide choice of “leisure” activities. By creating fun challenges and involving children in functional activities, arts and crafts, OTs help children gain strength, learn to problem solve, become more independent in their own care (dressing, bathing, chores), gain confidence and skills for social interactions, become more independent and ready to learn new skills and handle the challenges of the world they live in.
Suzette Werner Jones, OTR/L
President ,TherapyWorks, Inc.
Information from AOTA, Eleanor Clark Slagle lectures, Sensory Processing Disorder Website
by Phillip Kindschi | Apr 8, 2013 | Occupational Therapy
Nathan is a smart, spunky kindergartener who loves learning about animals and the environment. Nathan was getting into trouble at school for not keeping his hands to himself, interrupting the teacher and having difficulty remaining on task and staying seated. He began receiving occupational therapy about a year ago at TherapyWorks. While he had made some progress, his therapist recently implemented the How Does Your Engine Run?© Alert Program© to help improve self-regulation in order to decrease hyperactivity.
The Alert Program© was developed by occupational therapists Mary Sue Williams and Sherry Shellenberger in 1991, in order to create a shared language for students, parents, teachers, therapists and other professionals to use when improving self regulation and attention. According to their website, www.alertprogram.com, their mission is, “developing practical ways to teach people of all ages how to incorporate sensory integration theory into everyday living… and how understanding self-regulation can enrich the lives of children.”
The Alert Program© uses the analogy that your body is like a car engine; it can run too fast, too slow, or just right. For example, your engine is automatically running too fast if you are angry or are overly excited during recess.
Now that Nathan can accurately identify the engine level in himself and others, he has begun to learn different tools to use in order to change his engine speed. It is often a challenge to choose an appropriate activity to slow his engine and not simply pick a favorite activity!
Nathan is currently experimenting with changing his engine speed. He has learned body movement tools such as swinging, jumping, crashing, and climbing, used within a sensory diet for home and school, in order to calm and organize his engine to
the “just right” level. Next, he learned mouth tools such as resistive sucking through a straw (i.e. pudding or applesauce). Finally, hand tools, such as using a fidget toy or fabric fastener under the desk, keep his hands busy and his mind focused while learning.
His mother, Kimberly, has been very pleased with his progress in OT and using the Alert Program©. She explains, “In the past year, since beginning at TherapyWorks, Nathan has improved in so many areas, including self-regulation, social skills, attention and listening, behavior, coping skills, and so much more. He is now attending full days at school, whereas last year he was limited to half days. Nathan has always been an amazing, bright little boy, but he seems much happier and more confident now than when we first started at TherapyWorks. As a family we are so much better able to be successful and enjoy
each other. We are truly grateful to all of the amazing staff at TherapyWorks.”
How Does Your Engine Run?® and Alert Program® are registered trademarks of TherapyWorks, Inc.
TherapyWorks, Inc. 7200 Montgomery NE, Ste B9 Box 397, Albuquerque, NM 87109
Phone: (877) 897-3478; Fax: (505) 899-4071 Email: manager@AlertProgram.com Website: www.AlertProgram.com
