Congenital Muscular Torticollis: What is it and how can I help my child?

Infant smiling while laying on back

You may have heard the strange medical term “torticollis” from your pediatrician, neighbor, or friend. Frankly, it can be overwhelming and quite confusing to understand. In this post, we will review what torticollis is, reasons why babies may develop a torticollis, what parents can look for if they have concerns, associated impairments if left untreated, and tips on ways to prevent torticollis. 

What is torticollis?

The term torticollis is Latin for “twisted neck”. Congenital muscular torticollis (CMT) describes the posture of the head and neck caused by shortening or tightness of the sternocleidomastoid (SCM) muscle. This rope-like SCM muscle starts at the collarbone and sternum and inserts into the skull behind the ear. When this muscle contracts or is tight, it will cause the head to tilt towards the side of the muscle and rotate away from the involved SCM muscle. With this tightness, weakness on the opposite side of the neck may result. A torticollis is named for the side of the involved SCM muscle, either right or left.

What causes torticollis?

There is little agreement on what causes CMT. The most widely accepted theories include a difficult delivery requiring use of a vacuum or forceps and unusual positioning inside the uterus. Other risk factors for CMT include large birth weight, male gender, breech position, multiple birth, a primiparous (pregnant for the first time) mother, difficult labor and delivery, nuchal cord, and maternal uterine abnormalities.

What will a torticollis look like?

A baby with torticollis may present with the following: 

  • Tilt their head in one direction
  • Prefer looking at you over one shoulder rather than turning to follow you with his or her eyes
  • If breastfed, he or she may have trouble breastfeeding on one side or prefer one breast only
  • Have difficulty turning his or her head in one direction 
  • Some babies with torticollis will develop a flat spot on their head (plagiocephaly) caused by lying with their head consistently turned to one side
  • A small lump or “ropey” knot may also be felt in the neck due to a tight and tensed muscle. 

What can happen if a torticollis is left untreated?

An infant with CMT will be unable to have symmetrical movement of their head due to range of motion (ROM) and strength imbalances. If left untreated, associated impairments include jaw asymmetries, ear displacement, facial asymmetries, plagiocephaly, scoliosis (a curved spine), pelvic deformities and movement patterns that may affect normal development. 

What can you do?

If you have concerns that your child has torticollis or plagiocephaly, schedule an appointment with your pediatrician. Your doctor may teach you stretches and strengthening exercises to practice at home. They may also suggest taking your baby to a physical therapist (PT) for treatment. The skull is most malleable and with rapid brain growth during the first 3 months of life. This brain growth slows around 5-6 months. The sooner you address torticollis and plagiocephaly (especially before 6 months), the better and faster the outcomes!

While it is best for your baby to sleep on their back, incorporating various positions during supervised and awake playtime is great for strengthening his or her neck muscles. This includes tummy time, side-lying, and supported sitting. If your baby has a flat spot on their head, these positions can also help by relieving pressure off this area. You can do tummy time on the floor, on your chest, or even across your lap! Encourage your child to use their neck muscles to follow you or a toy with their eyes and head, especially turning their head to the side they least prefer. Start by working on this for 10-15 minutes total each day, gradually increasing as your child tolerates more. 

Another good way to encourage your baby to turn their head to their least preferred side would be to modify their room environment. This may include positioning their crib next to a wall rather than in the middle of their room. This will encourage your baby to use their weaker neck muscles to turn their head away from that non-exciting wall in order to look at whatever is interesting in their room. 

Questions or concerns?

If you have questions or concerns about your child potentially having torticollis or plagiocephaly, please contact us at info@playworkschicago.com or 773-332-9493. 

 

Elle Faerber, PT, DPT

Physical Therapist 

 

References: Campbell, S. K., Palisano, R. J., & Orlin, M. (2012). Physical therapy for children. Saunders. 

“Infant Torticollis.” Home – Johns Hopkins All Children’s Hospital, www.hopkinsallchildrens.org/Patients-Families/Health-Library/HealthDocNew/Infant-Torticollis. 

Photo Credit: Photo by Pexels at pixabay.com

April Showers Bring Sensory Powers!

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!

At-Home Olympics

Photo Credit: PublicDomainPictures via Pixabay

Do you love watching the Olympics? Now you can create your own version at home! At home Olympics can be a creative and fun way to provide your child with proprioceptive input as well as vestibular input. Proprioception is the sensory system that allows our body to understand where we are in space through our joints. Have your child participate in tug-of-war challenges to squeezing pillow challenges to provide this input. The vestibular system allows our bodies to understand what orientation our body is in space, how fast we are moving, and in what direction. Creating challenges from animal walk races to long jumping challenges can provide your child with the vestibular input they are seeking!

Scavenger Hunts

Photo Credit: iheartcraftythings

Scavenger hunts are a great way to provide your child with sensory input when cooped up inside from the rain. Have your child go on a scavenger hunt for different colored items, textures, or even smells. Provide additional sensory input by using animal walks to search room to room for the hidden items!

Crunchy Snacks

Photo Credit: Foodlion

Rainy day munching with a movie or game night is a great opportunity to provide your child with sensory input! Have your child help you prepare a crunchy snack to target their various senses, from interacting with different textures and smells to proprioceptive input from the big crunch. The crunchier the snack the more sensory input to their mouth!

Questions or concerns?

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

Urooba Khaleelullah, MOT, OTR/L
Occupational Therapist

Just Go to Sleep: Strategies for Improving Sleep Habits in Your Family

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.

Importance of a bedtime routine:

The first piece of advice that most people get about improving their sleep hygiene is to have a consistent bedtime routine. Maintaining a consistent bedtime routine is one of the best ways to help your child’s body know when it’s time to sleep. They will start to associate a particular time and set of actions with sleeping, which prepares their body for sleep before they even get into bed.

Establishing a routine goes beyond just having a set bedtime and wakeup time (although these should be as consistent as possible as well). A bedtime routine could start as early as a few hours before bed. Before bed, your child will need to brush their teeth, change into their pajamas, potentially take a bath or shower, and partake in whatever calming activities your family chooses. All of these activities should, ideally, be as consistent as possible from night to night. Try to make sure that all of these activities occur in the same order, at the same time, every night to help your child’s body recognize that bedtime is coming up.

Many experts recommend that beds not be used for for any activities other than sleep. If the bed is the place where your child sleeps, but also where they watch YouTube videos, play board games, hear a bedtime story, and do homework, then their body might be confused about what’s happening when it’s time to sleep. Consider moving those activities to a different location to help your child’s body understand that when it’s in bed, it’s time to sleep.

While it may be difficult to establish a highly structured bedtime routine every single night, establishing a routine and sticking to it as much as possible is one of the best ways to decrease sleeplessness for your child.

Using sensory regulation strategies to make a routine effective:

To make your bedtime routine as effective as possible, you might want to consider adding sensory regulation strategies into your normal routine! Sensory regulation refers to the body’s ability to take in information in the form of sight, sound, smell, taste, touch, proprioception (the feeling of where the body is in space) and vestibular awareness (a sense of balance and motion). When your body receives sensory information from the environment, that information can wake them up or calm them down.

Everyone’s response to sensory input is different, but generally, children find fast movement activities, like running or jumping jacks, exciting, while “deep pressure” activities, like being wrapped up in blankets, calming. Again, everyone’s different, so for some kids the opposite is true! However, this rule of thumb might be a good place to start: Try getting all of your exciting movement activities out of the way earlier in the day and stop them after dinner time, then, engage in some calming touch activities like a warm bath or massage as you start to get ready for bedtime.

It can be helpful to get a baseline idea of what calms or excites your child, so consider experimenting! Over the course of a few days, you can try out different activities and see how your child reacts to them. Is your child more active when you sing to them, or does it calm them down? Do they get energized by drinking a cool glass of water, or less? Here are some activities you could try to get a handle on your child’s personal preferences and responses.

Generally calming activities:
-Massage
-Being “squished” under pillows, or a weighted blanket, or having blankets wrapped tightly around them
-Taking a warm bath
-Slow rocking
-Chewing chew toys or gum

Generally energizing activities:
-Fast moving like running, jumping, or swinging
-Chewing something crunchy
-Drinking a cold glass of water
-Seeing bright lights, like a computer or television screen
-Hearing loud noises, including loud music

Once you know how your child responds to input, try to build a schedule that comprises of more energizing activities earlier in the day, then transitions to calming activities before bed. You can also try to incorporate these types of sensory input into activities you’re already doing; for example, if you usually read a book before bed, try having your child chew a chewy while you’re reading! This will help ensure you can develop a routine that’s effective for your individual child.

Other strategies for improving sleep hygiene:

If you’ve already implemented a sleep routine that incorporates calming input and your child is still having difficulties getting to sleep there are some other basic sleep hygiene techniques to try. Here are just some strategies you can use with your child to encourage appropriate sleeping habits:

-Make sure your child’s room is conducive to sleep. In general, people sleep better in environments that don’t have a lot of alerting light, aren’t too warm, are quiet and don’t have a lot of toys and objects to be distracted by. Your child’s room should be dark, cool, quiet, and uncluttered.

-Turn off screens before bed. TVs, cell phones, tablets, and computer screens produce blue light that tricks the brain into thinking it’s daytime. Try to limit your child’s screen time in the evening and stop all screen access for about an hour before bed. Once your child is in bed, take all screens out of their room to remove the temptation to get out of bed and start playing.

-Get enough exercise during the day. Children need a lot of movement to remain healthy and in control of their bodies! Make sure they have a lot of time outside, and a lot of time moving and playing before you start your calming routine after dinner.

Questions or concerns

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

Corrine Pratt, OT Student
Occupational Therapy Fieldwork Student

Photo credit: Simon Berger on Upsplash

Snow Day! Heavy Work Activities to Promote Sensory Regulation in Your Child

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.

What is heavy work?

Heavy work is a strategy used by therapists to target the sense of proprioception, helping children to understand where their bodies are in space. Heavy work refers to activities that push and pull on the body, specifically on the joints. When participating in heavy work activities, messages are sent from receptors in our joints to receptors in our brainstem. These messages serve to remind the brain and the body where we are in space. For children, this type of input is specifically helpful in promoting a calmer demeanor, increased attention and regulation, body awareness, improved sleep, and more organized behavior.

Try the following activities in the snow for increased opportunities for heavy work!

  • Have your child pull or push a peer or sibling on a sled. Heavy work is most effective when done until you child seems visible tired, so try supervising a trip around the block if your child seems up for it!
  • Have a snowball rolling contest! Compete with your child to see who can roll a bigger snowball. Pushing a large object, such as a snowball, provides excellent heavy work proprioceptive input to the shoulder joints.
  • Make a snow castle. Have your child pack snow into buckets, carry them to the other side of the yard or park, and flip them out to create a tower or castle. The body retains feedback from sensory input for about 90 minutes at a time, so you can always have your child go back and add on to his or her snow castle later in the day, when he or she may need more input.
  • Shovel! Shoveling is excellent heavy work. Give your child a shovel and allow him or her to help you clear off a porch, driveway, or some steps. Having your child carry the shovel full of snow over to make a snow pile will also be a great test of balance.
  • Explore some snow mounds. Supervise you child while he or she climbs up snow mounds made from shoveling or plowing. Walking uphill and through the snow provides plenty of resistance that makes for great heavy work!
  • Play snow hide and seek! Use a shovel to dig a hole and place a waterproof toy inside before covering the hole with snow again. Make sure this is a toy you wouldn’t miss in case it gets misplaced until spring! Have your child dig the toy out using his or her hands, a shovel, or a bucket.
  • Have your child pull a rake through the snow to create snow art!
  • Bury your child’s legs in the snow and let him or her move against the resistance of the snow to get out.

Questions or concerns?

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

Natalie Machado, MS, OTR/L
Occupational Therapist

Photo Credit: Katie Gerrard on Unsplash

What’s Inside the Mystery Box?!

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!

This language-rich activity is appropriate for children at every developmental stage AND it only requires a few common household items. There are endless outcomes, variations, and possibilities with this activity!

Materials

  • An empty box or container (plastic flower pot, clean mini trashcan, big bowl, toy bin)
  • A short sleeve t-shirt
  • A rubber band to secure the t-shirt (optional)
  • Small items from around your home

Directions

  1. Collect the materials
  2. Pull the t-shirt over the top of the box/container, so that one of the sleeves lines up with the top or opening of the container.
  3. (Optional) Secure the t-shirt onto the box/container with a rubber band
  4. Place objects from around your home into the mystery box/container through the sleeve hole at the top. Choose objects that are safe to the touch- avoid sharp/pointed items.
  5. Take turns reaching inside of the mystery box. Encourage your child to use his or her hands (or even feet!) to feel the objects in the box/container. Ask your child to pull the objects out. *BONUS: Create a silly song to sing while you pull objects out! This song is to the tune of “Mary Had a Little Lamb”

What’s inside the mystery box?

Mystery box, mystery box

What’s inside the mystery box?

I wonder what we’ll find!

 

How to target speech, language, and social development during this activity:

  • Play ‘peek-a-boo’ with objects in the box! After modeling this phrase a few times, pause and wait for your child to fill-in-the-blank. Encourage your child fill-in-the-blank with the object label by modeling the phrase “It’s….a…”. Pause, look expectantly at your child, and wait for him/her to fill-in the blank.
  • Increase your child’s eye contact and joint attention by holding the box and objects by your face! Tickle your child with the objects or place box on your head to increase shared attention.
  • Encourage your child to follow 1-2 step directions (grab the bear, then put it in the box; pull a soft toy out of the box). If your child needs extra support, provide a model or use gestural cues to show your child how to follow the direction
  • Model grammatically correct phrases and sentences throughout the activity. Label and describe what you feel, see, and hear. Incorporate different word types into your models, including:
    • Exclamations (uh oh, wow, ooooh!)
    • Object names (box, bear, shoe, stick, spoon, playdoh)
    • Pronouns (my, your, his, hers)
    • Action words (shake, pull, feel, reach)
    • Location words (in, out, under, up, down)
    • Descriptive words (big, little, hard, soft, squishy, smooth, bumpy)
  • Practice turn-taking by taking turns reaching inside of the mystery box. Identify whose turn it is by pointing and/or using turn-taking language (It’s my turn! Now, it’s your turn!). Encourage your child to wait and watch while you take a turn.
  • If your child is working on specific speech sounds, place objects in your mystery box/container that contain the target speech sound in the object label. Each time your child pulls an object out, you can practice the target word 5x together! For example, if your child is working on the “b” sound at the beginning of words, you can include objects such as a ball, bird, balloon, bib, baby, bell, banana, etc.
  • Ask your child to guess what objects are inside based on what he/she feels! Once the objects are out of the box, compare and contrast how the objects feel and look. Make a list of similarities and differences between the objects.
  • Sort the objects into categories based on color, shape, size, or object function (things you eat, things you wear, animals, vehicles, etc.)

Not only is this activity great for building language, but it also targets many occupational therapy skills, such as the ability to discriminate and identify objects based on touch without the use of vision, increasing focus and attention on the hands and the sensory system, and increasing impulse control (as your child has to wait until he/she finds the right objects, via touch, before pulling it out of the box).

 

Questions or concerns?

If you have questions or concerns about your child’s speech, language, and/or play skills please contact us at info@playworkschicago.com or 773-332-9439.

Nicole Sherlock, MA, CCC-SLP
Speech-Language Pathologist
Photo Credit: Nicole Sherlock

Play Together!

What Are the Benefits to Social Therapeutic Playgroups?

Play is the universal language of early childhood. It has been proven that children learn from each other. Therapeutic playgroups are interdisciplinary programs that allow children with developmental delays to grow through learning in a social setting. In this group setting, children learn how to foster their engagement by developing social-emotional and cognitive skills along with their peers. Therapists help facilitate organic social interactions between children. Therapists help foster relationships by encourage children to use them as a resource to engage with others. Playgroups are play-based programs that allow for children to be intrinsically motivated by their peers, grow their problem-solving skills, and facilitate social language in a sensory friendly environment.

The power of a play-based playgroup allow for children to grow their sense of self. Play therapy is used to promote cognitive development and social-emotional strategies to help children succeed in multiple environments. These play-based activities encourage children to problem-solve in a natural environment that is different from their home. Problem-solving skills are important for children to develop as these skills will be with them throughout their lives. In these playgroup children also learn how to follow directions. Children learn from peer models to follow familiar and novel directions. Peers grow their engagement for structured and unstructured play-based tasks by learning alongside on another. Unstructured tasks promote creativity and allow children to grow their symbolic play skills. Structured activities allow children to attend to adult-led activities and grow their task completion. The cognitive and social-emotional skills that children learn from playgroups allow them to succeed in a variety of environments and throughout their educational experiences.

 

Rachel Weiser, MS, DT
Developmental Therapist

 

Photo: PlayWorks Therapy classroom, Photographed by Thomas | © 2019 TK Photography |

Interoception: The Eighth Sense

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:

  • Bedwetting, constipation, and frequent accidents
  • Identifying appropriate ways to dress for the weather/temperature
  • Not being able to identify hunger, thirst, sickness, pain
  • Self-regulation, self-awareness, and emotional outbursts
  • Having flexible thoughts and behaviors
  • Problem-solving
  • Social skills and participation

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 Therapy74(4_Supplement_1), 7411505251p1-7411505251p1. https://doi.org/10.5014/ajot.2020.74S1-PO9513

 

Photo Credit: Ketit Subiyanto via https://www.pexels.com

SNOW WAY! Sensory Activities for Winter Days

Winter can be cold and snowy, but it’s always a wonderful time to engage in different sensory activities! Use the snow, cold weather, and holiday season to expose your child to countless sensory-based play activities, both indoors and outdoors. Playing with objects of various scents, textures, colors, and sounds, or engaging in activities that require your child to move their body in different directions and transition between various positions are great for providing sensory input. This will help them learn more about the world and how to process the sensory information they are constantly receiving.

Build a Snowman

Do you want to build a snowman? Yes! Getting outside to roll snowballs and build a large snowman provides great proprioceptive input. Proprioception is also known as the “joint sense” and lets us know where different body parts are in space, how they move, and how much pressure our body wants or needs to stay regulated. Encourage your child to pack the snow in their hands, roll it on the ground to gather more, and build massive snow balls to stack on top of each other!

Watch those Snowflakes

While you’re still outside, why not lie in the snow, make some snow angels, and stare at the snowflakes falling down? This provides great visual input! You and your child can pretend you’re inside a snow globe, looking at all of the snowflakes falling around you. You can also gather snow in your hands and encourage your child to blow it into the air! This provides great oral and visual input, all while your child is simply enjoying the snow day.

Sip Something Tasty

Go on inside and warm up with some hot chocolate! Sipping and sniffing a warm cup of hot-cocoa will give your child some great tastes and smells for their sensory system to process. Put a spin on the classic hot chocolate by stirring it with a candy cane or adding whipped cream or marshmallows. The added flavors and textures will provide increased oral input for your child.

Create a Snow Sensory Bin

Sensory bins are a great way to explore different textures, colors, and smells in one place! Help your child create a snow sensory bin by gathering some snow and adding other items. Feel free to include items from outside, such as rocks, leaves, or sticks. Add some from inside the home too, such as spoons and cups to scoop and pack the snow. Hide waterproof toys inside the bin and encourage your child to search for them. Sprinkle some glitter, paint, or food coloring into the bin for a visually-exciting spin on the usual white snow. The options are endless!

Questions or concerns?

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

 

Morgan Haak

Occupational Therapy Student Intern

 

References

Proske, U., & Gandevia, S. C. (2012). The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force. Physiological reviews92(4), 1651-1697.

 

Photo Credits: Nelly Aran via Pexels; Victoria Borodinova via Pexels; Nelly Aran via Pexels; Jill Wellington via Pexels; Matej via Pexels

Green Screen Teletherapy

I spy, dinosaur hunts, and apple picking, oh my! As pediatric therapists, we have been faced with the challenge of engaging children of varying ages and diagnoses over teletherapy. Children, families, and even therapists are still getting used to this virtual format. I want to walk through some ways I have utilized green screen technology for speech therapy during my time as a graduate student clinician at PlayWorks Therapy, Inc. I have found that using the green screen technology creates a fun and engaging way to target goals, while keeping our clients’ attentions for longer periods during our virtual telehealth sessions.

How do you use green screen technology?

Green screen technology is easily utilized over Zoom (PlayWorks’ medium of delivering teletherapy).

To set up the green screen: You need a green screen, or another brightly colored background. Mine is a plastic green tablecloth hung with command hooks. Next, log into zoom. Click the up arrow in the “stop video” button on the lower left corner of the zoom window and click “choose virtual background…”. Now, in your camera view, there is a small circle in the bottom right that has a color. Click that circle, then click your mouse on your background in the camera view. This tells Zoom what color to detect as your background, so it can transfer your given image to your green screen.

To transfer activities to Zoom backgrounds: Download/export your activity in a “.jpg” format to your computer. Follow the above directions to get to the virtual backgrounds settings. Then, click the plus sign (+) to upload the background images.

What goals can be targeted in green screen teletherapy?

I have targeted my clients’ speech and language goals using elements of the green screen. I have even used the same green screen activity for clients of varying ages and goals by modifying the way I use the activity, my language level, and my prompts. Using green screen activities is a great way to create a “theme” for each week. Being fall, my clients have enjoyed a variety of fall-themed activities from apple picking to exploring a spooky mansion for Halloween.

Articulation

Articulation is easily targeted using these curated, story-like green screen activities. For example, for the apple picking activity, courtesy of “GoGo Speech”, I will have the client say their given target word 5 times, put the word in the sentence, and then we pick the apple together. You pick all the apples this way, but watch out for the worm who just might eat all our precious apples!

Language

Language goals can be targeted as well, including expanding language to age-appropriate utterance lengths, spatial concepts, pronouns, wh- questions, and more. I have used “I Spy” to practice expanding a child’s phrase length. I have used “GoGo Speech” materials for spatial concepts, where the clients must tell me where they see the chipmunk during our picnic: “is it behind me? Is it on top of the rock? In the tree?” I have used a “fall hunt” activity, modeled off of the classic “we’re going on a bear hunt” story, to target wh- questions and expressive language. The opportunities are endless!

What are some go-to resources?

My go-to resources come from a private Facebook group, entitled “Green Screen Speech Therapy”. Speech-Language Pathologists post many resources that can be downloaded, personalized to meet your client’s speech and language goals, and then added to Zoom for use during a speech therapy session. This Facebook group also has an incredibly useful video explaining how to set up a green screen and how to use it. My other go-to has been “GoGo Speech”. If you subscribe to their services, they send activities for free (and videos on how to use them) to your email inbox.

Is green screen technology only useful for speech therapy?

Other disciplines can use green screen technology to keep their client engaged and target goals simultaneously, too! This means that physical therapists, occupational therapists, social workers, and developmental therapists can use green screen resources as well.

Do I have to have a green screen to use these resources?

No, you do not. You can download the resources in a PowerPoint format. Then, share your screen during your sessions to take advantage of the same resources without having a green screen.

 

Gwen Berglind, B.S.

Speech-Language Pathology Graduate Student Clinician

 

Credits: “GoGo Speech”, “Green Screen Speech Therapy” Facebook Group

Express Yourself: Building Self-Esteem

Self-Esteem and self-confidence are something we think of adults either having or lacking… but can kids either have or lack these skills? (Answer: Yes and yes!)  And if so, how do we help boost a child’s confidence and self-esteem?

What is self-esteem?

Self-esteem is having the confidence in one own’s worth and abilities, in addition to self-respect.

What is self-confidence?

Confidence is the trust in oneself, a measure of faith in one’s own abilities.

Why is this important for children to develop?

A positive sense of self is important for children to develop in order to establish and maintain a healthy lifestyle, coping skills, and interpersonal relationship skills with others. Having increased self-esteem and self-confidence is essential for children to grow up with a positive mindset, have the ability to try and complete new challenges, and identify their strengths. Children who are mindful of their self-esteem and self-confidence levels, have the potential to manage unexpected stress with more resiliency and the ability to accept and forgive themselves and others.

How can I improve my child’s self-esteem?

You can increase your child’s self-esteem at any time: during the day, when they are trying something new, or picking out their clothing.

  • Start by giving your child lots of praise (“I’m so proud of you!”)
  • When giving your child praise, explain what they did and why you are proud of them (“I’m so proud of you for cleaning up after yourself by putting your dish in the sink.”)
  • Identify their differences and support their choices (within reason), even if they are not always correct. (“I love the way you used *pipe cleaners* to build the wall, very creative!”)
  • Try as much as possible to stay and remain positive with your child. They will imitate and learn from your reactions. (“It’s so frustrating we are lost, let’s do some teamwork to solve this together.”)
  • Identify and comment on positive traits and characteristics about your child (“Wow Johnny, you climbed all the way to the top, you are so strong, brave, and determined!”)
  • Be supportive, understanding, and caring when your child fails. (“I know learning how to ride a bike is tricky. You are tough, hard-working, and intelligent! We will keep practicing together when you’re ready.”)

 

Questions or concerns?

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

Kelly Scafidi, MSW, LCSW, DT
Licensed Clinical Social Worker
Developmental Therapist

Photo Credit: Haydn Golden via Unsplash.com