It’s Reflexive! Retained Reflexes and Their Effect on Development

 

Retained primitive reflexes are immature movement patterns that can often have effects on a child’s overall development. Naturally, these reflexes should “integrate” or disappear during infancy. When a reflex is retained, more mature movement patterns are not developed, which can have an effect on sensory integration, posture, executive functioning skills, and overall neuroplasticity. Recognizing and treating these retained reflexes can have a big impact on a child’s overall development. 

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Spot the Difference: Understanding Vision and Perception

 

Your child is sitting in the exam room chair for their annual eye check-up, and they are asked the notorious question that you always seem to overthink: “Which is better… 1… or… 2…” Did you know that optometrists are testing for visual acuity when they ask that question? But did you also know there are many more aspects of vision than just visual acuity that could be influencing your child’s ability to learn and play? Read on to learn more about how to spot the difference between visual skills!

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Crawling, Can My Child Skip It?

 

Why is crawling such a big deal? What if my child doesn’t seem interested in crawling? These are all common questions that are brought up by parents. Crawling is much more than just a means of mobility. It provides a child with some important strengthening, coordination, and cognitive benefits that will help them much later than the baby and toddler years.  

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Criss Cross Your Midline!

The crowd goes wild! Your child has just swung and hit their first home run! They run around the bases and go to touch home plate. Your child is showered with high-fives from teammates on the left and right. Among other things, in order for your child to have successfully swung and hit a home run, run around the bases, and give high-fives to his teammates, your child would have to have done one really important thing… cross midline! The ability to cross midline and interact with all areas of our environment is an important skill for all of us to learn. Let’s explore!

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Little Yogis: Benefits of Yoga for Children

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?

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Brush It Off! Brushing Protocol for Sensory Integration

Therapeutic brushing may be recommended for your child due to tactile defensiveness, or difficulty tolerating a variety of textures. However, engaging in a therapeutic brushing protocol may also help to ease sensory-based anxiety, promote falling asleep, increase attention to task, increase coordination, and overall self-regulation.

What is Therapeutic Brushing?

The Wilbarger Deep Pressure and Proprioceptive Technique (DPPT), also known as the Wilbarger Brushing Protocol, is often used by occupational therapists to promote sensory integration. It is typically used with children demonstrating sensory defensiveness, or children who exhibit signs of over-responsiveness in the protective responses of the nervous system. Oftentimes, it is used with children who exhibit tactile defensiveness, or difficulty being touched by people or a variety of textures.

What Does the Protocol Look Like?

DPPT begins with systematic brushing of the body, followed by joint compressions to a child’s arms, legs, hands, feet, and head. Brushing is completed using a soft surgical scrub brush, often called a Therapressure brush. The correct brush is required in this protocol, as it provides a specific type of sensation to the nerve endings in the skin. Firm, even pressure is used to sequentially brush the arms, back, legs, and feet. Areas such as the stomach and chest are always avoided, as they are particularly sensitive. Following brushing, 10 joint compressions are provided to the child’s hands, wrists, elbows, shoulders, hips, knees, ankles, and feet using gentle pressure. This provides the child with deep pressure proprioceptive input which is calming to the nervous system. The protocol is repeated approximately every two hours while the child is awake. DPPT must always be taught by a trained therapist to ensure that it is safe, effective, and beneficial for the child.

What Does Brushing Do for Sensory Integration?

The brushing portion of DPPT stimulates the nerve endings of the skin, generally serving to “wake up” the nervous system. The joint compressions provide the body with deep pressure proprioceptive input, which typically calms nervous system. Performing the two elements of the protocol helps the central nervous system to better utilize information from the nerve endings of the peripheral nervous system more effectively. This can result in increased overall regulation, decreased anxiety to sensory triggers, and improved ability to transition between challenging tasks.

Who Would Benefit from Therapeutic Brushing?

Your child may benefit from DPPT if he or she:

  • Demonstrates difficulty being touched, wearing a variety of clothing, or tolerating a messy play.
  • Becomes reactive with grooming activities, including having his or her hair washed, or fingernails clipped.
  • Demonstrates difficulty maintaining a calm, alert, and organized state.
  • Experiences difficulty calming down and falling asleep at night.
  • Demonstrates difficulty transitioning between activities
  • Appears to have trouble noticing when he or she is hungry or needs to go to the bathroom.

Questions or concerns?

If you think your child could benefit from DPPT, please reach out to your occupational therapist or  us at info@playworkschicago.com or 773-332-9439.

Natalie Machado, MS, OTR/L
Occupational Therapist

References:

OT-Innovations.com. (2018). Therapeutic brushing techniques. Retrieved from https://www.ot-innovations.com/clinical-practice/sensory-modulation/therapeutic-brushing-techniques/.

Keep Calm and Messy Play On!

Ever wonder why most of us have a baby photo with food all over our hands and faces? An important part of processing our world is through touch, even from a young age. Our sense of touch gives us information about our environment and the characteristics of our surroundings. We are able to determine if something is hot, cold, sticky, dry, soft, smooth, and so on! Messy play is a vital part of child development as our touch processing feeds into our skills such as motor planning, body awareness, visual-motor skills, fine motor skills, and more. At the moment with our schools and businesses closed many of us may be stuck indoors as we quarantine at home. While our current focus might be keeping our hands and homes clean, we can find ways to continue promoting our tactile sensory processing and get messy safely!

Our sensory processing abilities determine how we respond to tactile input. Your child may demonstrate sensitivity or avoidance to tactile input, such as withdrawing their hands when they get messy or splaying their fingers outward when they engage with wet textures. Maybe your child craves tactile input and you have a hard time keeping their hands clean or to themselves. Either way, incorporating messy play or multi-sensory experiences into their day can help them learn to process and respond to tactile input in order to better participate in grooming, meal time, bath time, and other daily routines!

Sensory Materials from Home:

You can always try to repurpose materials that you already have in your home to promote messy play. Try filling up a plastic bin at home with any of the following. You can switch out the material weekly to continue providing a range of tactile sensory experiences.

  • Cotton balls or pom poms
  • Feathers
  • Dried foods: pasta, rice, beans, oats, corn, seeds, coffee beans
  • Wet media: shaving cream, frosting, whipped cream
  • Slime, Gak, Flarp
  • Kinetic sand
  • Beach sand
  • Potting soil
  • Beads
  • Small rocks
  • Shredded paper
  • Water with ice cubes
  • Packing peanuts

Messy Play Activities at Home:

  • Have your child help you cook or bake
    • Roll dough, wash vegetables, mix batter
  • Art
    • Finger paint! Paint your child’s hand and make hand prints on paper
    • If your child has a hard time using their fingers use cotton balls, Q-tip, or a paint brush
    • Use halved apples, peppers, or celery to make vegetable stamps with paint
  • Homemade PlayDoh
    • Add essential oils for a multi-sensory experience
  • Hide puzzles or activities inside of a sensory bin
  • Make a mess with shaving cream in the tub during bath time
  • Practice letter formation in wet messy play such as whipped cream
  • Have your child help you garden by planting seeds or flowers in soil
  • Have your child wash their toys in soapy water
  • Hide beads inside of Theraputty or PlayDoh
  • Play barefoot in grass or sand
  • Blow bubbles and encourage your child to pop them with their fingers or toes
  • Make spaghetti or pasta and color with food coloring for edible messy play
  • Make clough dough or moon sand at home
  • Make homemade gak or slime
  • Go on a nature hunt and collect leaves, sticks, rocks for a nature sensory bin

Make messy play part of your child’s daily routine by adding it to their sensory diet activities or designating a day for messy food play at meal time. Increasing your child’s experience with messy play will help them learn how to process and respond to tactile input and tolerate a variety of textures and materials. It can also be a motivating way to engage children when you are stuck indoors.

Questions or concerns?

If you have questions or concerns about your child’s responses to tactile or sensory input, please contact us at info@playworkschicago.com or 773-332-9439.

Robyn Geist, MS, OTR/L
Occupational Therapist

Photo Credit: JBryson via istockphoto.com

Reuse and Recycle for Reclaimed Fun

Bottles, boxes, and bins…oh my! With everyone quarantined at home for COVID-19, recyclable materials are likely piling up! You may be thinking, “what can I do with all these toilet paper rolls?” Here are a few fun ideas using commonly recycled items. These projects will not only keep children entertained, but also target important developmental skills.

 

Toilet Paper Rolls

With all the toilet paper rolls around the house now, try making binoculars with tape, paper, and string. Play I Spy, and find objects of a particular color or shape to target those early categorization skills. You can also create a bowling set for turn-taking and eye-hand coordination. Decorating the tubes in any way will require plenty of precision and coordination as well!

 

Cardboard Boxes

Round up all of those food boxes and make some new puzzles! If you have older children, have them practice their cutting skills by creating the pieces. The thickness of the cardboard requires a greater amount of strength and coordination to cut. Have your little ones complete the puzzles. You can also use these boxes for imaginative play, like this fun car parking garage.

 

Plastic Bottles

The possibilities are endless with plastic bottles. Put raw beans or rice inside of them for homemade maracas, make a science experiment lava lamp, or use them during bath time for pouring and filling. You can also create animals for container play for young ones to practice fine motor skills. Or have your older children get creative for some cute spring planters.

 

Questions?

If you have questions about how to use other materials or how to adapt an activity specifically for your child, please contact us at info@playworkschicago.com or 773-332-9439.

Kristen McManus, MOT, OTR/L
Occupational Therapist

What’s So Fine About Fine Motor Coordination?

Do you remember back when you first learned to zip up your own jacket? How about tie your shoes? Write your name for the first time? Color carefully to stay inside the lines? You may not have known it then, but as a child you built many of the fine motor coordination skills you still use every day. When you think of “coordination” you might think of playing sports or swimming, and you would be right! However, when we talk about fine motor skills, we also use the word “coordination” to describe how many different muscles in your hands are working together to accomplish the smallest of movements.

Fine motor coordination involves learning many different skills simultaneously in order to have more control and precision over tools or objects in order to be accurate. These skills include having strength in the small muscles within your hand and fingers, developing a good grasp on tools, moving items around your hand without dropping them, and developing precise targeting. As your child practices these skills, he/she will refine these skills to help learn the foundational skills in many different areas of development. In general, large motor skills (stability of the head, core, controlled limb movements), become more consistently accurate before fine motor skills.

What skills should my child have now?

  • Around 12 months: Pulling off socks, starts to finger feed self with small table foods, can use a spoon to dip, grasps objects of different sizes, uses their whole hand to grasp around writing utensils, places and releases small objects down on a flat surface
  • Around 24 months: Pulling off untied shoes, can use a fork to pierce food, and a spoon efficiently to transfer food, shows an interest in scissors but may not be able to open and close them with one hand, may use a pronated (thumb side of hand down) grasp on writing utensils, they are starting to pick up small items and tuck them into their palm, they are starting to place items from the inside of their palm down by passing them to the finger tips, they consistently rotate items 90 degrees using just their finger pads (such as when taking the top off a small twist top jar)
  • Around 36 months: Unbuttoning large buttons on a jacket, pulling on socks with some help, can open and close scissors, and snip through paper, may continue to use a pronated (thumb side of hand down) grasp on writing utensils
  • Around 3rd birthday: Putting shoes with Velcro fasteners, putting on socks, zipping and unzipping a jacket (help putting both sides together at bottom), buttons large buttons on a jacket, starts to use scissors to cut through paper, over the next year practices pushing scissors forward to cut on a line, starts using a three-finger grasp that is looser and their arms and shoulder move lots when coloring
  • Around 4th birthday: Able to put together jackets that have a snap or hook fastener, some snaps on pants, zipping jacket independently, puts on shoes (needs help with tying laces), can put a belt through loops, pushes scissors to cut out simple shapes, over the next year starts cutting curved lines and circles, your child continues to get more efficient and accurate with drawing with their three-finger grasp, they are able to separate two pieces of paper by rubbing their fingers together
  • Around 5th birthday: Can tie knots, improved accuracy with scissors, the child uses a dynamic grasp (three fingers on utensil near the tip, their shoulder/arm are stable, their fingers and wrist are controlling movements, they are more accurate and efficient with this grasp, they can adjust their grasp on a pencil by moving it between their fingers
  • Around 6th birthday: Can tie a bow, independently manage shoes, other clothing fasteners, can cut more complex figures, they can flip a pencil around to reach the eraser without picking up and moving the pencil, they can pick up small items sequentially while holding other small items in their hands

My child isn’t ready to tie their shoes or write yet; why do these skills matter now?

Fine motor coordination skills are built over a long period of time, and gradually get more complex as a child gets older. Foundational skills in this area, such as grasping tools and moving small items from the palm to tips of the fingers, are key for later important skills such as writing, typing, cutting, money management, using utensils to eat, tying shoes, and managing fasteners on clothing. A child may become successful and efficient with navigating these skills as they continue to develop other skills through play and participation in daily routines.

Why do occupational therapists work on these skills?

Occupational therapists focus on these skills because they are a part of our daily living skills, from putting toothpaste on our toothbrush, to getting dressed, to participating in school, and feeding ourselves! Children use their fine motor coordination skills during daily living activities, in education, and in play, all areas which are covered by the domain of occupational therapy! During an occupational therapy evaluation, a therapist would look more in depth at your child’s fine motor coordination skills for their age.

What can I do?

  • Play games while picking up small items with kitchen tongs, chopsticks attached at the top with a rubber band and paper, or a straw bent in half to form tongs
  • Snap/button art boards
  • Puzzles with different snaps, buckles, locks to open
  • Read books with flaps to lift up to reveal pictures below
  • Practice tearing paper with your child, crumpling it up between your fingers, and using it in an art project, such as gluing it onto a snowman outline to make it 3-D.
  • Make a paper cup lantern by pushing a paper clip through the side of the cup and place an LED tea light inside
  • String beads or pasta on spaghetti noodles, string, or pipe cleaners
  • Make PlayDoh with salt, flour, and cream of tartar. Roll it into snakes, small balls, build tiny snowmen
  • Let your child practice opening items in the house for food consumption, such as bags of chips, twist off applesauce pouches/water bottles,
  • Tape small animals to a baking sheet and practice pulling the small pieces of tape off
  • Cut a slot in the top of an oats container. Have your child practice placing popsicle sticks in the slot; recreate this activity with Q-tips and a plastic lid with a straw hole, sort coins into different piggy banks
  • Stretch rubber bands around the outside of a small jar
  • Pull pom poms or other small items out of a kitchen whisk
  • Decorate cookies and allow your child to pick up the small sprinkles and push them into the dough
  • Let your child have as much practice as possible with fasteners (snaps, buttons, zippers, and shoe tying)
  • Cut through different layers/thicknesses of paper (tissue paper, paper, paper plates, cardboard)
  • Increase your child’s opportunities to practice writing outside of school by having the child write the score of a game, write letters to family members, write the list of items needed at the store
  • Use a stylus if your child plays games on a device. There are apps to practice coordination while using a stylus such as: iTrace, LetterSchool, Dexteria Jr, Writing Wizard, Trace it/Try it
  • Paint using the ends of Q-tips to make small dots on paper to draw fireworks
  • When recycling boxes, have your child cut the box instead of breaking it down for extra scissor practice
  • Allow your child to practice peeling fruit, picking the stems off the ends of beans, etc.
  • Hide toys in small jars and bottles, and have the child practice getting them out by twisting open the top

Questions or concerns?

If you have questions or concerns about your child’s fine motor coordination, please contact us at info@playworkschicago.com of 773-332-9439

Caroline Stevens, MS, OTR/L
Occupational Therapist

References: Fleming-Castaldy, Rita. (2019). National occupational therapy certification exam review and study guide. 8thedition. Therapyed.

Photo Credit: Markus Spiske via unsplash.com