These past 2 years have been a whirlwind. With the transition from in-person to virtual and back to in-person school, less opportunity for socialization, along with the uncertainty of what life will look like each day; it’s no surprise that we are seeing an increase in childhood stress and anxiety. So, what strategies can we provide to ease the stress our kids are facing today?
Not only do April showers bring May flowers, but with these rainy days also come the perfect opportunity to have your child engage in fun and exciting indoor sensory activities to get their creativity flowing!
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We all know sleep is important for maintaining a healthy, happy lifestyle. Unfortunately, sleep doesn’t always come easy, even to children. Some children, especially those with sensory processing issues and other difficulties, struggle to get to sleep and remain asleep through the night. What’s more, chances are, if your child isn’t sleeping, you aren’t either. The result is a cranky, sleep-deprived child and a cranky, sleep-deprived adult. Here are some strategies for improving your child’s “sleep hygiene,” or habits that promote healthy sleep.
Snowy days provide great opportunities for heavy work proprioceptive input! Proprioception refers to our sense of awareness of body position, which our bodies process by receiving input through the muscles and joints. This type of input is typically calming for most children, but can also be alerting for some children. Proprioceptive input generally occurs through heavy work activities that involve deep pressure or weight through the muscles and joints.
Let’s make a mystery box!
It’s no mystery that families and children been spending more time at home than ever before. When we are constantly surrounded by the same scenery, including the same toys and games, it can be difficult to brainstorm ways to mix it up (without constantly rushing to the store or clicking ‘buy now’ on Amazon).
As a pediatric therapist, I am always seeking new ways to turn every day household items into fun, motivating, and enriching toys. I’ve found that some of the best toys are not ‘toys’ at all. One of my favorite non-traditional toys is a do-it-yourself mystery container/box!
Our sensory system is how we experience the world around us, and when we have difficulty processing one or more of these senses, our daily experiences can be hugely impacted. Children also use their senses to take in the world around them and learn new skills, whether through watching a bubble float by with their eyes, feeling gooey slime squish between their fingers, or tasting that delicious piece of cake with their tongue. While some of the senses are better known, there are others that are “hidden,” but equally as important in your child’s development. Some children have difficulty processing sensory information and producing a response that is appropriate, which can be seen through a variety of challenges in completing important daily activities. Understanding what our senses do for functioning is the first step in improving our ability to process them!
What is interoception?
It is likely that you learned about the “five senses” sometime early in your life: touch, taste, smell, sight, and hearing. These senses help you initially interact with the world around you and are important in helping you participate in everyday activities as an infant and young child. As you got older, you may have learned of the next two senses that are not as obvious but still very important to daily functioning: the proprioceptive and vestibular sense. Proprioception is the sense that identifies the position of your body in space with the use of receptors in your joints and muscles, and the vestibular sense helps us with movement, balance, and controlling our posture.
Interoception is the eighth sense we have; it is often called the “hidden sense” because it is not something we can see, but what we feel on the inside of our bodies. Imagine it is 2:00 in the afternoon and you have not eaten since 7:00 in the morning. Your stomach starts to make a growling noise. That is your interoceptive system working to let you know that you are hungry and that your body needs food to maintain a balanced state. When responding appropriately, you would recognize that sound and feeling to mean hunger, and you may go to the kitchen and get a snack.
Our interoceptive sense allows us to feel important body functions like hunger, pain, nausea, itch, needing to use the bathroom, coldness, and even emotional states such as nervousness, fear, or excitement. This sense uses internal signals that tell us how our body is feeling and can give clues to how we can respond to restore balance and find a place of comfort. Our bodies want to feel regulated, and how we get there may be different for everyone.
What does it look like when a child has difficulty with the interoceptive sense?
When the interoceptive sense is not processed appropriately, your child may have difficulty understanding what the signals inside of his/her body are trying to communicate and then will have difficulty responding appropriately to these messages.
Generally, this means challenges with:
Self-regulation, or the ability to monitor and manage your emotions and behaviors, is a vastly important aspect to consider with your child who may be struggling with interoception. For example, your child may not be able to feel or recognize getting angry; that is, a faster heartbeat, the face getting hot, or muscles tensing. Your child will then have difficulty identifying that these feelings mean anger, possibly not even until the emotion has already produced an inappropriate response. Without understanding and being aware of how these body sensations are making us feel, it will be difficult to identify the emotion being experienced and react in a way that is appropriate.
How can occupational therapists address interoception skills in children?
As daily occupations (i.e. using the bathroom, dressing for the weather, interacting with friends) are often affected by our understanding of our internal body sense, occupational therapists have a role in working with children who may have difficulty with the interoceptive sense. Occupational therapists (OTs) at PlayWorks follow guidelines from the Interoception Curriculum, a program designed by Kelly Mahler, a licensed occupational therapist and expert in interoception.
Using a step-by-step framework, OTs work to improve awareness of sensations within the body by introducing body experiments and body checks. These activities seek to improve your child’s understanding of how his/her body feels and can enable him/her to respond appropriately to improve participation in daily activities. Following this curriculum, OTs may also use a visual representation of the body to aid in recognizing and understanding body signs. This can be accomplished by using a visual drawing of a person with different body parts, combined with a list of different sensations or describing words. This will enable your child to practice matching the descriptor words to different body parts to increase understanding and connection of internal body cues and daily activities.
What can I do to support interoception in my child?
While interoception should be addressed in therapy, you can also support these challenges while at home. It will be helpful to start labeling body language as you notice it during different activities. For example, you can say, “I see that your breathing is getting heavy and your face has become a little red. I think you might be feeling angry.” This may help to link specific body language to emotions that they are feeling.
Additionally, you can try out some mindfulness activities, such as meditation, yoga, or reading a book centered around being mindful. While doing so, you can point out or ask how their body is feeling when they are doing these different activities to bring awareness to internal body cues. While this may be a challenging sense to understand for some children, there are many ways we can work with you and your child to increase his/her knowledge and recognition of these cues to improve participation in daily activities!
Questions or concerns?
If you have questions or concerns about your child’s interoceptive sense, please contact us at info@playworkschicago.com or 773-332-9439.
Molly Ross
Occupational Therapy Student Intern
References:
Interoception: The Eighth Sensory System (2016). Retrieved from https://docs.wixstatic.com/ugd/b303b5_ab07aaedc04c45b3a96e519fc262ecd1.pdf
Mahler, K., McLaughlin, E., & Anson, D. (2020). Interoception Across Varying Degrees of Mental Wellness. American Journal of Occupational Therapy, 74(4_Supplement_1), 7411505251p1-7411505251p1. https://doi.org/10.5014/ajot.2020.74S1-PO9513
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Have you ever heard someone say that your brain is not fully developed until age 25? When someone mentions that, it’s usually to explain how teenagers can still make risky decisions, even when they feel like near adults because their “decision making warehouse” in their brain is still making new connections. That’s true! The frontal lobe of your brain is responsible for many of your executive functioning skills! So, what does that have to do with your child? Executive functioning skills that are required for all those complex adult decisions begin with foundational skills that emerge in early childhood that are necessary for your child to pay attention, finish tasks by themselves, and stay in control of their body and reactions. All children need to develop well-rounded executive functioning skills for success in the classroom and at home.
What are executive functioning skills?
Executive functioning refers to a complex collection of skills across areas of neuropsychological development that include how your child’s brain is able to focus on one subject, plan ahead, organize, follow steps in order, follow familiar routines, have self-awareness, hold thoughts in our memory, switch between activities, and control our responses to events. In general, executive functioning skills are responsible for our general external and internal organizational and attentional processing. In general, executive functioning skills help us make a decision or goal, plan how to achieve that goal, carry out the steps in the plan, and check that we were able to do it right.
What does it look like when a child has difficulty with executive functioning skills?
Executive functioning develops typically in children who are participating in learning opportunities with gradually decreased support from an adult, everyday social interactions, games that challenge inhibition or memory, and lots of trial and error with activities. Early signs of difficulty with executive functioning skills may look like any of the following:
What can I do to support my child’s executive functioning?
Infancy:
Toddlers:
Early Childhood:
School Age:
Executive functioning challenges are common in children with Attention Deficit Hyperactivity Disorder (ADHD), autism, anxiety disorders, and learning disabilities. However, not all children with difficulties in these areas may have one of those diagnoses. If your child is demonstrating persistent problems with some of the skills above, consider contacting one of our occupational therapists, who can provide your family with helpful tips and tricks to build your child’s executive functioning skills.
Questions or concerns?
If you have questions or concerns about your child’s executive functioning skills, please contact us at info@playworkschicago.com or 773-332-9439.
Caroline Stevens, MS, OTR/L
Occupational Therapist
References:
Center on the Developing Child. (2020). Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence. Retrieved November 5, 2020, from https://46y5eh11fhgw3ve3ytpwxt9r-wpengine.netdna-ssl.com/wp-content/uploads/2015/05/Enhancing-and-Practicing-Executive-Function-Skills-with-Children-from-Infancy-to-Adolescence-1.pdf
Cramm, H., Krupa, T., Missiuna, C., Lysaght, R., & Parker, K. (2013). Broadening the Occupational Therapy Toolkit: An Executive Functioning Lens for Occupational Therapy With Children and Youth. Retrieved November 06, 2020, from https://ajot.aota.org/article.aspx?articleid=1863088
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Fall is a season full of creative activities to do both indoors and outdoors. Use this season to expose your child to creative and different sensory play activities to get their imagination flowing. Sensory exploration can occur through different textures, smells, visual input, and even using something ordinary in a new way.
Paint a pumpkin
Finger painting a pumpkin exposes your child to a whole new world of painting. From the slippery textures of the paint to the rough texture and ridges of the pumpkin your child will be able to allow their imagination to run wild on this novel canvas!
Photo Credit: Shaunna Evans via Fantastic Fun and Learning
Pumpkin carving
Gooey gooey goodness! Pumpkin carving is a great way to encourage your child to get hands-on with a mixed texture…the gooeyness of the inside of the pumpkin mixed with the firmness of the pumpkin seeds. This activity is a great way to promote your child to engage in more messy play!
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Crunching and jumping in leaves
Crunching in your hand or even stomping with your feet, fall leaves are a great way to engage your child in sensory play using a familiar object. Have your child help in creating a leaf pile to jump into to get their senses ready for the big jump. The crunchier the leaf the better!
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Fall sensory bin
Creating a fall sensory bin is a fun and exciting way to explore the different textures and smells of this season! Have your child help in creating the bin to increase their excitement. This bin can be created using all sorts of textures and everyday items from dried corn, popcorn kernels to pine cones and even cinnamon sticks to get their senses ready for the season.
PlayWorks Therapy
Questions or concerns ?
If you have questions or concerns about your child’s responses to different sensory inputs, please contact us at info@playworkschicago.com or 773-332-9439.
Urooba Khaleelullah, MOT, OTR/L
Occupational Therapist
What does it mean to “cross midline,” and why is it important?
The ability to cross midline involves moving a body part across the center of the body (midline) to the opposite side in a smooth or fluid manner. This movement is essential for learning to use both sides of the body together. This skill is closely associated with brain development, as the two sides, or hemispheres, of the brain must communicate to coordinate learning and movement. Crossing midline promotes a child’s ability to reach for and explore new toys or objects, learn to creep and crawl, develop patterns for self-feeding, and interact more fully with the environment as infants and toddlers. As children continue to grow, crossing midline becomes an important skill needed for the development of fine and visual motor coordination.
If a child is unable to cross midline, they may tend to use their left hand to complete activities on the left side of the body and their right hand to complete activities on the right side of the body, impeding their ability to develop a preferred or dominant hand. Hand dominance impacts a child’s ability to use tools effectively, including pencils, markers, and scissors, so difficulty crossing midline often affects handwriting, cutting, and other school-related fine motor tasks. A child’s ability to smoothly cross midline with their eyes, arms, and legs also plays a significant role in developing reading skills, eye-hand coordination, gross motor skills, and independence with self-care tasks and impacts overall quality of movement within age-appropriate activities and routines.
Difficulties with crossing midline may be present if your child:
How can midline crossing and coordination be encouraged at home?
You can support continued development of your child’s ability to smoothly cross midline during a variety of daily activities, using toys and items you likely already have at home:
Continued practice with crossing midline will promote overall fine motor, visual motor, and gross motor coordination for improved independence in self-care, recreational, and school-related activities throughout your child’s day.
Questions or concerns?
If you have questions or concerns about your child’s ability to cross midline, please contact us at info@playworkschicago.com or 773-332-9439.
Caitlin Chociej, MS, OTR/L
Occupational Therapist
References:
Cermak, S., Quintero, E.J., and Cohen, P.M. (1980). Developmental Age Trends in Crossing the Body Midline in Normal Children. The American Journal of Occupational Therapy, 34(5), 313-319. https://dx.doi.org/10.5014/ajot.34.5.313
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PlayWorks Therapy Inc. is committed to ensuring your child receives quality services during this time of uncertainty and have transitioned to all online teletherapy sessions. We are looking forward to this virtual experience with you!
What is Teletherapy?
Teletherapy, also referred to as telehealth, is a type of therapy provided by your child’s therapist online through video chat, much like FaceTime, Skype, or Gchat. Although teletherapy is a new offering at PlayWorks Therapy, it is a model of therapy that has been used and researched in the field for several years. PlayWorks Therapy is remaining current with best practice and continuing to provide evidence-based therapy through this mode of therapy.
What can I expect from a Teletherapy appointment?
Depending on the type of therapy your child receives, the structure of the therapy session may differ slightly than the in-person appointments. The session itself may consist of the therapist reviewing goals and techniques with caregivers as well as assisting in choosing appropriate toys, games, and materials to target those goals. The therapist would then provide recommendations for how to use each material, including specific prompts to use throughout the activities. We realize that your child may not be as engaged or motivated to sit in front of a video so we require a parent or caregiver to be present or nearby for the majority of the session.
Will this really be a productive mode of therapy for my child?
Many providers have been using teletherapy as their primary mode of therapy over several years with success. Because the structure may look different than usual the in-person appointments, our expectation of what makes a “productive” or “successful” session may also change. Your child’s goals may shift slightly in this period but just know that every and any interaction your child has with their therapist informs their continued work. With a strong partnership, both the therapist and caregivers can use techniques with the child to reach targeted goals.
Won’t it be awkward that my child and the therapist are in different rooms?
At first, some children do find it slightly awkward or uncomfortable to work with therapists virtually. Below are strategies we recommend trying to increase your child’s comfort level with this new type of appointment:
I’m not great with technology. Will this be challenging to set up?
In most cases, your teletherapy appointment will take place on a website or app platform. Your therapist will communicate with you about your child’s specific platform, and whether or not to download an app, based on what type of therapy they receive. Your therapist will then send you a confirmation email with the link and any other information you will need to access the appointment. It will be as simple as opening your email and selecting the link! You will then be directly connected to your therapist’s video chat.
I am in the appointment, but now I am experiencing a problem with the connection.
Below are technology tips to help you get the most of your therapy sessions:
Questions or concerns?
If you have questions or concerns about your child’s eligibility for teletherapy, please contact us at info@playworkschicago.com or 773-332-9439.
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