The Back to Sleep campaign rolled out in 1994 as an initiative to decrease the risk of SID, or sudden infant death syndrome. While this campaign has been successful in decreasing the incidence of SIDS, most people forget to finish the full sentence. Back to Sleep, Tummy to Play!
Placing your infant on their back during sleep times is safe practice, having your infant on their belly while they are awake (and being monitored) is very important for development.
Tummy time can promote:
Strong muscles in the trunk, arms and back, including strong neck muscles resulting in good head control
Development of appropriate spinal extension and rotation, which are both pre-requisites for walking
Initiation of exploring one’s environment, starting with vision and leading to reaching out for objects, rolling and eventually crawling
If a child remains on their back for a majority of their day it can lead to complications such as torticollosis, plagiocephaly or brachicephaly. These issues can lead to developmental delay, including asymmetries with crawling and walking.
What if my child hates being placed on their tummy?
Use some technique to make it a little easier for them!
You lay in a recline or semi-reclined position and place your child on your chest. Being in a reclined position eliminates some of the resistance of gravity, making it easier for your child to lift their head. This can also be used as great bonding time with your infant.
Have your infant lay over a boppy pillow, so the pillow is under their chest with their arms and shoulders in front. This position is similar to having them lay on your chest, decreasing the resistance of gravity.
Making tummy time fun!
The more time your child spends on their tummy the more they will enjoy it.
Get down on their level! Position yourself to be in line with your child’s eye site
Place different toys on the floor that are motivating for your infant to play with, such as music toys or light up toys. The toys can be placed to either side of your infant’s head or directly in front of them.
Babies love looking at themselves! If you have a mirror or a toy with a mirror attached, place it on the floor in a position where they can see themselves.
Make sure you have enough space for your baby to explore. It starts with just lifting the head and will progress to turning 180 degrees on their bellies to crawling!
One of my favorite resources as a pediatric occupational therapist to help kids begin to understand and process emotions as well as come up with strategies for self-regulation is the Zones of Regulation curriculum developed by Leah Kuypers. The Zones of Regulation helps teach kids how to self-regulate and deal with everyday strong emotions or unexpected emotions for different social environments.
The zones can be compared to traffic signs. When we see a green light, one is ‘good to go’ and can keep proceeding forward without making any changes. A yellow light, on the other hand, means to be aware or take caution. Sometimes we can keep going and other times we need to make a change. A red light (or stop sign) means stop. Often the behavior we are demonstrating is unexpected. The blue zone is most often compared to the rest area sign where you go to rest or re-energize.
When teaching children to begin using the Zones of Regulation, I tend to follow three stages of learning.
In stage one, the child learns how to identify the terminology and sort emotions according to the physiological features of each specific zones
Frowning, yawning, crying = blue;
Happy, calm, focused= green
Upset, butterflies in stomach, Heart beating fast = yellow;
Yelling, body feels tenses = red).
In this stage, there is a lot of detective work and identifying features of body language. I like to use a variety of pictures, books, and movie clips when possible to help during stage one.
In stage two, children start to learn strategies to adjust their zone and help them manage their internal emotional feelings. Children learn a variety of sensory motor strategies (e.g. swinging, taking deep breaths, walking, squeezing something) as well as cognitive behavioral strategies (e.g. expected versus unexpected, size of the problem, inner critic versus inner coach, stop/opt/go).
In stage three, children are more independent and are beginning to select appropriate tools to help with self-regulation. Depending on the child’s age, supports might still be in place such as visuals for choosing appropriate tools.
It is important to remember that ALL of the zones are expected to occur at one time or another. At some point we may feel tired in the Blue Zone, calm in the Green Zone, worried in the Yellow Zone, and possibly furious or elated in the Red Zone.
The Zones of Regulation focuses on teaching children how to manage their zone based on the environment and the people around them. The Zones of Regulation was designed to support people in managing all the feelings they experience, without passing judgment on what people are feeling or how they are behaving.
Leah suggests four main points to keep in mind with beginning to use the Zones of Regulation with any child:
It is natural to experience all of the Zones; there is no bad zone.
Our Zone is defined by the feelings and internal states we experience on the inside.
Our behavior is a byproduct of how we manage our Zone; therefore, consequences should not be tied to a Zone.
The context we are in helps us figure out how to manage our Zone so our behavior meets the demands of the social environment, and in doing so we are able to achieve the tasks we are trying to accomplish and/or the social goals we’ve set for ourselves in that situation.
Here are some additional tips to help kids develop their emotional intelligence and emotional self-regulation:
Provide as much stability and consistency as possible. Consistent limit-setting, clear household rules, and predictable routines help children know what to expect. This is turns help them feel calmer and more secure.
Model, model, model. We cannot do this enough. How we react and deal with emotions will establish the foundation for how those around us will also respond. We usually don’t have a choice in what we feel, but we always have a choice about how we choose to act regarding our feelings. Children learn from us. When we yell, they learn to yell. If we remain calm and speak respectfully, they learn to do the same. Every time you model in front of your child how to respond to an emotion, your child is learning.
Connect. Spend time everyday unplugging and connecting with your child. Young children first learn how to regulate by being soothed by their parents. When you notice your child getting dysregulated, the most important thing you can do is try to reconnect.
Name it and Accept It. Calling attention to your child’s feelings helps them understand what is going on inside them and learn that it isn’t okay to feel different emotions. Your child will know that someone understands, which might make him or her feel a little better.
Amazon describes the Echo as a hands-free, voice-controlled device that uses Alexa (Amazon’s answer to Siri, Cortana and Google) to play music, control smart home devices, provide information, read the news, set alarms, and more. It is exciting that people’s interactions with a computer device is much easier with no buttons to find and press. The speech recognition still has some limitations but devices like the Echo show what the future may be around the corner. The Echo works by constantly listening to a trigger word, by default, the trigger word is “Alexa” but you can change it in the Alexa app on your mobile device. The communication devices we use in assistive technology allow a non-verbal child, or the child with some difficulty in oral speech to use the Echo independently.
Relationship Coordinator, Amy Liss, really enjoys this new device. “This is the most beneficial piece of technology I have ever received that can help me be completely independent.” Her favorite feature is playing daily Jeopardy trivia.
Some of these many uses:
Get quick answers for simple Web searches: The most basic use of the Echo is to ask it questions it can answer by searching on the Web. This ranges from simple math (Alexa what is 125 times 33?”) or spelling and definitions, etc. The Echo is unique in that it will say the answers out loud rather than requiring the user to read the responses.
Set alarms and timers: So children with executive functioning is ability to self-regulate, including the ability to stay on task and manage and keep time. For example, you can set a timer for someone to do an activity for one hour (“Alexa set a timer for one hour”) then set a second timer for each separate step that needs to be completed to accomplish the assigned task during that hour. Just say “Alexa set a second timer for 25 minutes. So you can have a 5 minute break.
Manage a to do list: Just say “Alexa, add (name of to do item) to my to do list, or remind me to (name of task).”
Update your calendar: “Alexa, add (event name) to my calendar.” Gives the ability to stay organized.
Get your daily news fix: (“Alexa, give me my Flash Briefing”)
Listen to Audible and Kindle books: The Echo is a great way to listen to your books read aloud. This can be a great way to use the Echo in the classroom setting.
Control your lights: Echo can be great way to control your home lighting using just your voice. This can be especially helpful for those who have motor difficulties. By installing the Hue Skill, you can get basic voice control of the lights in your home.
Control your appliances: With a Wemo switch you can add voice control to any small appliance with an on/off switch (fans, lamps, etc.)
Listen to music and podcasts: Echo supports a number of music services.
There are many more thing you can do with the Echo. For more details go to www.luisperezonline.com for full details. If you have a voice that is difficult to understand, have no fear- Alexa can use many speech generating devices to the rescue.
The Assistive Technology department at Easter Seals DuPage & Fox Valley has received a grant to install Amazon Echo in their department. Once it is installed we hope that you all will come down and give it a try. Learn more about our assistive technology department by clicking here.
I’ve been an occupational therapist for seven years and it’s taken a long time to perfect the answer to the question “What is OT?” from people I just met. Today, I think I finally have a good answer.
To begin, occupational therapists see individuals across their lifespan and in a variety of different settings. We work closely with medical staff, parents, and educators. Typically there is some underlying problem that has initiated a meeting with an occupational therapist.
Depending on their training, there are a number of different approaches an OT may take to solve the problem. One approach is the “Person, Environment, Occupation” (PEO) model. The PEO model (Law et al., 1996) is a well-known and established conceptual model of practice within occupational therapy. It offers a foundation for guiding assessment and intervention across all practice settings and client populations.
This model of practice helps an OT consider the whole child…their roles, activities, where their performance may need help, areas of strength, and more. Since I work with children, I am going to define the person as a child. The environments are the places a child interacts (e.g. home, school, community) and the occupations are the things he/she does in those places (e.g. get dressed, feed themselves, learn to write/color/draw, play). It is an occupational therapist’s job to evaluate a child and determine what makes it hard for those occupations in all his/her environments. It could be strength, sensory, visual, etc. or a combination of all those areas. It could also require a team approach, short term services, or long term services.
Let’s look at an overview of the assessment process with a simple case study to make it easier to understand:
ASSESSMENT PROCESS (Person, Environment, Occupation)
Referral: A 7-year-old is referred by a doctor for occupational therapy services based on her parents’ concerns with difficulty sitting still at home and completing homework tasks. She also has difficulty focusing and getting ready for the morning.
An OT would consider the child’s role as both a developing child, sibling, daughter, student, and friend. What is preventing her from participating fully in those roles? We would also consider the family’s values, interests and daily roles. We try to look at the client’s pattern of engagement in occupations (i.e. getting ready) and how they changed over time.
In the example above, we would consider the entire family. This child has many roles. She is not only a child of a two parent working family, but she is also a sibling with a younger brother. She is also a first-grade student. In further conversations, we discover she also participates in gymnastics after school. In order to best support this child and her family, we would need to consider each of those roles and how they contribute to the overall profile of this child.
Occupational Performance Areas:
Then we consider the areas of occupational performance (e.g. activities of daily living, instrumental activities of daily living, rest and sleep, education, play and leisure, and social participation).
In the example above, this child is possibly presenting concerns with activities of daily living. Specifically, we might look at her ability to dress herself and completing grooming/hygiene tasks. Her mother, also mentions the child is having difficulties with staying focused and managing her assignments in school. Is this also impacting her social participation both at home, school and community where she does gymnastics?
Occupational Performance Components:
What components need to be addressed that may explain underlying difficulties?
Body Structure and Function– This may include muscle tone, range of motion, posture and alignment, postural control, strength, joint stability, endurance, fine motor skills, manipulation and dexterity, gross motor skills, coordination, bilateral coordination, etc. We may also evaluate her nutrition, respiration and gastrointestinal background to make referrals.
Sensory motor – This may include a child’s under or over responsiveness to touch, movement, sight, sound, taste and smell as well as their visual perceptual skills and body awareness. This may also include a child’s behavioral responses to activities.
Cognitive – This may include perceiving, understanding concepts, learning, and executive function skills (initiating, planning, organizing, sustaining, sequencing, flexibility, problem solving, managing emotions, etc.). We may make referrals to further understand the role cognition plays in your child’s abilities.
Social-Emotional – This may include self-regulation, self-esteem, as well as inner drive and motivation to participate in activities. It could also include the ability to relate to other children and adults.
In the example referral above, we would need to determine what areas of occupational performance are making it difficult for her to participate to the best of her abilities. We could evaluate her strength by having her climb to see how she manages her body in space and uses her arms to support her body weight. We might also look at her core strength to see if she is weak and if that is causing her to feel unstable while sitting which impacts focus (e.g. if she is having to concentrate hard on keeping her body upright to be able to use her eyes and hands, then it will be hard for her to also concentrate on math facts).
We will also look at her hand skills. There might be concerns with weakness, grasp, manipulation, etc. that make it hard for her to use writing tools to complete tasks.
We can create a sensory profile, by asking questions, having a parent fill out questionnaires, and observing a child during activities. We would use our background in sensory integration too during our observations. For example, perhaps the feeling of clothing is too irritable to this child and she is having trouble focusing because she is needs to move to readjust how her clothing feels on her skin. We can evaluate vision to determine if we need to make a referral to another doctor. By planning some activities to do together, we can look at how her sequencing and planning behavior.
Finally, occupational therapists are mindful of the social-emotional development of children and how difficult things impact his/her daily function. We might ask the parent further questions if we notice that she is getting frustrated easily during a task and has trouble managing her frustration.
There are many hats that an OT wears in this therapeutic relationship….another adult, parent, teacher, friend, etc. When we begin, we often know very little about each other. However, we work together and figure out plans that best help a family address their wants for their child. In the process, we may not know all the answers yet and it may take time to figure them out. That is one of the hard parts of an OT’s job but also a fun aspect too. Wearing these different hats while at the core serving as an occupational therapist, is what I love about my job. To learn more about Easter Seals DuPage & Fox Valley’s occupational therapy services visit: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/occupational-therapy.html.
If you are looking for the perfect holiday gift for your child, here are some ideas to give your little one the input they are looking for over winter break. I also included other helpful websites, stores and catalogs for children with special needs.
Heavy Work and Movement
Cuddle Me Sensory Tunnel– Great for therapy requiring tactile input and crawling practice as well as for sensory seeking kids to cuddle in for comfort. $49.99
Santa’s Little Hackers– A seasonal toy drive to adapt toys, making simple modifications to the electronics of toys and giving them away. These adaptations make the toys accessible to individuals with disabilities so they can play independently.
Other Adapted Toy Resources:
Adaptive Tech Solutions: Adaptive Tech Solutions is a therapist owned and operated company that provides adapted equipment for individuals with disabilities at affordable prices.
Beyond Play: Features switch toys which are wonderful way to teach cause and effect and can help children develop a sense of control over their environment and self-esteem.
It’s true, now that the weather is getting cooler, many locations will finally get a break from Zika and other mosquito-borne illnesses. However, we Midwesterners like to escape the cold and travel to the tropics, so this is a reminder to pack insect repellent spray! The following are answers to some of the most common questions asked.
Where are the current outbreaks?
The best source of information is the CDC website where they have travel notices and the latest updates. Currently the only area in the U.S. with active spread from mosquitoes is in South Florida, near Miami. In fact, on October 13, CDC expanded it’s warning area where there are new Zika cases. Click here for specific advice for people traveling to South Florida.
What are the symptoms?
The vast majority of people who become infected don’t have any symptoms at all. However, if symptoms do develop, they include the following symptoms:
Joint and muscle aches
Symptoms typically last for 2-7 days after an incubation period of about 2 weeks.
How is it transmitted?
Mosquito bites are the initial mode of infection. We now know that individuals can then transmit Zika to others via sexual activity long after the initial infection from the mosquito. There have also been a couple rare cases where it is unclear how the person contracted the virus.
How long is someone contagious?
There is currently research underway to determine this. The recommendations are that people who have traveled to an area with known active Zika abstain from sexual activity for at least 3 months, preferably 6 months if there was known infection confirmed by laboratory testing.
How is it diagnosed?
The Zika virus can be detected in blood or urine. However, there are a limited number of labs that perform this test and all have to be sent and reported via the Illinois Department of Health.
How do I prevent getting infected?
Insect repellent with at least 25% DEET (not for children under 2) is best and wearing light colored clothing helps prevent mosquito bites. Staying in cooler air conditioned areas also is advised. Condoms do protect against sexual transmission.
Is there any treatment?
There is currently no cure or medication for Zika infection and it will be several years before a vaccine is developed. If you have traveled to an area with active Zika cases it is recommended you call your physician with any specific questions.
Feel free to comment below or email me at firstname.lastname@example.org with any questions you may have concerning the Zika virus, and I will make it a priority to get back to you!
Editor’s Note: Dr. Liu has provided family medical care for thousands of patients of all ages over two decades and now. She is board-certified in family practice and licensed without restrictions. She currently serves on the board of Easter Seals DuPage & Fox Valley and is also a member of the Illinois Academy of Family Practice Committee on Mental Health. Dr. Liu is proficient in all aspects of primary care, but holds special interests in women’s health and travel medicine. Read her previous post on new patient care models.
Many parents will tell you that trips to the doctors office, specialists, etc. can sometimes make for stressful moments for children and families. When a child has complex needs, the level of stress can be increased. Once you consider factors and obstacles such as medical emergencies and other personal issues that a family may be dealing with, those appointments become tougher to make.
It is important for doctors and other specialists to be mindful and reevaluate the judgments they make on parents and caregivers. Before drawing conclusions on why a child may be missing appointments, it is imperative to consider the entirety of that child’s life.
Here are a few tips on how specialists can be more understanding of families:
Be Mindful: One important thing to remember is that in the vast majority of cases, no one is more concerned with the well-being of a child than that child’s parents and family. If there are appointments being missed or a lack of communication, there is likely a good reason behind it. Forming a solid grasp of this is a huge step in better understanding a client or patient.
Check for Signs: Often times, it is possible to gain a sense that something external may be happening in a child or family’s life. When you are visited by a patient or client, try to look for signals. Are there any noticeable signs of stress? Are there any patterns in appointment cancellations? Asking yourself these questions can lead to meaningful answers.
Appropriately Ask the Family: If you are unable to gain insight using the previous tip, think of a kind way to inquire information from the parent/caregiver. This can be done by simply asking how things have been going. By kindly asking how the child and family has been, or even asking about recent medical history, you are beginning dialogue that could help you understand the root of inconsistencies.
Acknowledging the lives of children and families outside of just the scope that you see them in as a specialist is a significant step in building better relationships with them. It’s important not to make assumptions, as they can often lead to uneasiness.
Today is Giving Tuesday, the global day of giving. This international movement started in 2012 to channel the generous spirit of the holiday season and inspire action around charitable giving.
Watch Abbey’s video on how she gained independence through the therapies she received at Easter Seals DuPage & Fox Valley. She is now a sophomore at Yale University and is helping clients like Clover achieve independence too.
Today, thanks to three generous individuals, the first $7,000 raised will be matched 1:1! This means your gift can make double the impact!
Your involvement on this global day of giving will impact all the life-changing services and programs at Easter Seals which help children with special needs develop brighter futures.
Over the past few years, computers, tablets, phones, and TV seem to have taken over. Technology has begun to change the way our children interact with each other and us. However, how much time spent on these devices is considered too much?
<18 months: Avoid use of screen media other than video-chatting.
18 to 24 months: If you want to introduce digital media, choose high-quality programming. Also, watch it with your children to help them understand what they’re seeing.
2 to 5 years: Limit your children’s screen use to 1 hour per day of high-quality programs. You should watch it with them to help them understand what they are seeing and apply it to the world around them.
6 and older: Place consistent limits on the time spent using media, the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.
What are the potential effects of too much screen time?
Obesity: Too much screen time equates to more time spent in sedentary positioning resulting in decreased physical activity and weight gain. The American Academy of Pediatrics recommend for children to get at least 60 minutes of active play daily.
Sleep: Devices emit a blue light that mimics daylight, which stimulates you, leading to irregular sleep schedules and shorter duration of sleep with use of a device before bedtime.
Behavioral problems and violence: Screen time can be an effective way to calm down, but it should not be the only way they learn to calm down. Children should learn how to identify and handle strong emotions and come up with ways to manage them (such as deep breathing or problem solving)
Loss of social skills: Face-to-face communication or “talk time” is critical for language development. Research has shown that it’s that “back-and-forth conversation” that improves language skills—much more so than “passive” listening or one-way interaction with a screen.
What can you to to help?
Set time limits and expectations
Create “tech free zones” such a dinner table or bedrooms
Use screen time to promote education and development by utilizing appropriate programming.
Screen time for the purpose of passive consumption should be limited, as it does not activate a young child’s brain the way that real interaction with another person does. Children learn most efficiently from back and forth communication, interaction in the real world and hands on play.
However, the screen can be a platform to promote back and forth interaction between a caregiver and child. Here are my favorite apps that promote creativity, collaboration and FUN interaction:
Video Star lets you easily create a music video in which you are the star! Select the song, special effects, start shooting and then watch back the hilarious video that you created!
Songifytransforms your recorded speech into a song. It is SO FUN!!!
Puppet Palsis an app in which you can create your own unique puppet shows. You can select the actors, background, animation and record the audio.
Funny Movie Maker lets you replace the mouth (or entire face) of a picture of a friend, celebrity, pet, etc. You can record videos, adjust the pitch of your voice and add music to complete your video. I think this could be an entertaining way to get that articulation homework done!
Book Creatoris a simple way to make your own book right on you tablet. In this app, you can customize books by adding pictures, text, video clips, music and even your own recorded voice. What a great way for a child to re-tell a previous event or create their own imaginative story!
As with all media use, play these games along with your child. These apps may spur your creativity too!