Category: Teletherapy

Staying Sane while Staying Home

By: Kelly Nesbitt, MOT, OTR/L, Occupational Therapist

Response to Coronavirus (COVID-19) 

Kids are finishing up the school year, you are still going to work/working remotely, running your home, and keeping your kids entertained during their summer! All this change can be very disorienting and stressful for everyone.  I wanted to put together a list of some suggestions that are “occupational therapist-approved” to help you navigate staying sane, keeping a good routine, carving out “family time”, and receiving therapy services remotely while being stuck inside the house! 

Routines

Probably the largest disruption to all of us at this time is that all of our daily routines are completely changed! Daily routines help provide structure to our lives, whether you are a child or an adult. Research by Ruth Segal, OTD and Assistant Professor in the Department of Occupational Therapy at New York University, reports that daily routines give families as sense of identity, organization, and provide socialization opportunities (Segal, 2004). Our kids are used to having a predictable day involving school, extra curriculars, play dates, and therapy appointments which help them organize their days and have meaningful interactions with family and friends. With this change to e-learning and staying home, it’s completely understandable that kids may feel stressed, anxious, and aimless without their routines. This stress may be more exacerbated for children with Autism Spectrum Disorder (ASD). Children with ASD can be heavily reliant upon predictability and routine, which have been thrown off because of the Coronavirus. For both neurotypical and children with ASD alike, using visual schedules, timers, and social stories may be good techniques to help your child cope with a new routine. 

Visual Schedules

Visual schedules can be as complex or simple as you need; they can be simple drawings on a piece of paper, an excel spreadsheet, or printed words/pictures from an online generator. For some of my clients, they are comforted and reassured when I draw 3 pictures of activities we are going to do in OT.

Honestly, whatever works for your kid and helps them feel organized is correct.  Whatever way you decide to create a visual schedule, it’s important to build in both structured and unstructured time for your children. They should have time built in for their academic work for school as well as a few hours for play time that is completely unstructured. Some kids may want to put a sticker next to an activity they completed, erase it on the whiteboard, cross it out, or just put a checkmark next to it. The sky’s the limit! Below are some examples of visual schedules and who it may be appropriate for:  

(Written schedule with times, appropriate for older elementary children who can tell time) 

(visual picture or words, as they are able to read. You can draw your own pictures or just print some off for younger children who cannot read.)  

More resources at: Free Templates for Daily Visual Schedules 

Timers

In conjunction with visual schedules, it can be helpful to utilize timers (sandtimers, timer on the microwave, on your iPhone, etc.) to help your children keep organized. The timer you use will have to be dependent upon your own child’s level of development as well as what they personally need to feel supported. Apps you can use: 

  1. Children’s Countdown App: Great, free time app on smart phones that shows a picture countdown on the screen. The coundtown clock can be set for any amount of time and children do not need to understand how to tell time or have understanding of numbers to comprehend it.
  2. Timed It! App: App for older children in which you can put in personalized tasks in minute increments and the app will help the child count down until they need to move on to the next task.
  3. Timer on smart phone: just about all smart phones have a “clock” application in which there are capabilities for setting a timer. This would be good for older children who have a better sense of what an hour, minute, second is. Although, some younger children will understand the concept that they are only “all done” when the timer makes a sound.

Social Stories

For some children with ASD, social stories are a good way to help explain why their routine has changed or what the “story” of their day. Social stories are third person stories in which the child is the main character and different themes can be explored. Ask an Occupational or Speech therapists for help creating a social story, if needed. 

Here’s a link to example social stories and one of the final links on this page has a social story template: https://www.andnextcomesl.com/2018/07/free-social-stories-about-transitions.html.  

Reducing Stress Activities

 In this uncertain time, it’s important to have some outlets for both you and your children to decompress and still have fun together. Building in sensory activities into your daily routine will help your child remain calm and regulated throughout the day.  

Physical Activities and Heavy Work

Taking movement breaks throughout your day will help both you and your child stay sane while you are cooped up at the house.  Occupational therapists often discuss the benefits of heavy work and how this push, pull, or carry input (or proprioceptive input) to the muscles and joints has a regulating and calming affect. There are a multitude of heavy work activities you can do indoors. Such as:

  1. Build a pillow fort with blankets, pillows & stuffed animals
  2. Pull siblings on the hardwood floor while they are sitting or laying on a blanket
  3. Do animal walk races across the room (bear walk, frog hop, crab walk, etc. Make up your own silly walk!)
  4. Jumping Jacks or jump on a trampoline
  5. Pull siblings in the wagon around the block
  6. Have a wall push-up competition and find out who is the strongest in your house
  7. Play towel tug-of-war
  8. Plant flowers in the backyard or help with yard work (using little shovel, pull weeds, dig in the dirt)

My helpful tip to parents is, if the activity includes pushing, pulling, or carrying something; that’s heavy work! Get creative and come up with your own ideas!

Family Game Night/Nightly Mealtime Tradition

Keeping special family routines will be important to make sure kids feel safe and supported when everyone is kind of stressed. Set aside time in your routine where you can all sit down and have a meal together with the television off. A family tradition at my house growing up was to play “Pot Boils Over” where one member of the family starts a silly story and after a few sentences says “pot boils over” and “passes” the story-telling to another family member to add on as they please. It’s a simple game that gets all family members involved, laughing, and thinking creatively.

Another mealtime routine I have heard of, is going around and saying one thing each family member is thankful for, what the best part of their day was, share a good joke, etc. This is also a great time for families to all sit down together and have game nights. You are going to be all home together, why not build some special memories and encourage social learning. Here are a few favorite games that can be played with multiple people, for different ages:

  1. Games for younger children: Shoots and Ladders, Simon Says, Twister (help them with right and left), Follow the Leader, Go fish, Memory (match pictures by turning over cards), Jenga, Kerplunk
  2. Games for Older children: Twister, Uno (each color you play can correspond to a fun activity such as “Make up your Own Dance Move” or “Do 2 Pushups”), Clue, Scrabble and Scrabble Junior, Telestrations (like telephone, but with drawing pictures), Apples to Apples, do a 200+ piece puzzle as a family, Guess Who?

Here’s another resource with more games: Our Favorite Board Games for Kids

Unplug

I am personally feeling inundated by COVID-19 news and I can get overwhelmed quickly, so I can imagine you and your children are feeling the same. I think it’s healthy to be aware of the evolving situation and current precautions, however it’s beneficial to “unplug” every once and a while when you are at home with your kids. Your children are very perceptive and can pick up on your stress and anxiety as they read your non-verbal cues and affect. Young children especially need their parents to “co regulate,” meaning they read your affect, mood, facial expressions and adjust their own regulation accordingly. If you exude a calm, cool, collected attitude when they are anxious, this will help them calm down and feel secure.

Therefore it’s important to turn off the news at some point and focus on having quality and uninterrupted play time with your kids. Do finger painting, make a fort out of blankets, play board games, read stories by flashlight, sit together and do a puzzle or color! Even just being available to your children, not distracted by technology or work, can be extremely beneficial to your kids.

As May is Mental Health Awareness Month, the CDC also recommends to take time to pause and breath during stress. Notice How you Feel. Take Breaks. Make time to sleep and exercise. Reach out and stay connected. Seek help if you are feeling overwhelmed or feeling unsafe. If you or your child needs help, our social work team can help.

Tele-Therapy Services

COVID-19 does not have to stop your child’s progress toward their goals! Your child can still receive therapy services remotely via tele-therapy.  Tele-therapy is a unique service delivery method in which your friendly Easterseals therapist will arrange a time and will send you a link via the Microsoft Teams app. From there, you just click on the link at your pre-arranged appointment time and you can have a video call with your therapist. Your therapist can then work on therapy goals with your child with you, the parent, being the therapist’s “hands” in the session. An occupational therapist will help coach you through appropriate handling techniques, sensory strategies, exercises, fine motor activities, feeding session and more remotely!  

All our therapists adopted this technology so your child will continually receive services with minimal interruption. It is our hope to keep providing exceptional therapy services to all of our clients during this difficult time. If you have any questions or concerns regarding tele-therapy, please reach out to one of your therapists or contact us at 630.620.4433.

Also stay tuned to our blog for more resources and tips from our therapists on helping families cope with increased time at home during COVID especially during the summer.

Sources:

Tele-therapy at Easterseals

By: Valerie Heneghan, M.A., CCC-SLP/L, Director of Speech-Language, Feeding, and Assistive Technology

Tele-therapy for All! 

Easterseals DuPage & Fox Valley has been at the forefront of serving children and their families in a way that meets their current needs through clinical expertise, a team-based approach and integrating technology to ensure maximum independence. As an organization, we have been offering tele-therapy opportunities for the past 10 years as a service delivery model to those it would serve optimally (i.e., a generalization of skills to home environment, transportation issues, medically fragile or at-risk health, to accommodate busy schedules, etc.). 

In response to COVID-19, all 87 therapists were trained to transition to tele-therapy services within two days with support from experienced tele-therapists within the agency.  

How Does Tele-Therapy Work? 

Once evaluated to determine eligibility for skilled therapy services, your therapist would follow up to plan your child’s tele-therapy session and schedule a time to meet. They will work with you to review treatment plans and establish your priorities. 

Laptops or desktop computers are preferred for best overall experience. But tablets, iPhones and Android phones can work too as long as the device has a working microphone and camera. A stable internet connection is needed via a hard-line/Ethernet cord, WiFi or using your cellular plan (your standard data rates may apply). Screen sharing is available to increase participation, engagement and utilization of resources throughout the session. 

Boy in Physical Therapy with Tele-Therapy

Tips for Making the Most out of Online Therapy

  1. Get comfortable with the technology: Immerse yourself in the platform you are using. There are often a lot of features available such as audio adjustments and visual displays, screen sharing, chat features, etc. The more comfortable you are with these features the easier it may be to modify or troubleshoot if a technical problem occurs.
  2. Make a plan: Plan out a time and a designated space in your home that would work best for your child. Have the computer, phone or other device propped up on books or a stand that has a wide view of the room. If possible, the therapy time should be away from other family members or pets. Work with your therapist ahead of time to prepare a few materials or resources like balls, pillows, mats, or games. 
    • Ex: For a young child, find a space where the child can sit comfortably to view the screen but also has space nearby for movement breaks. Bring your child’s favorite toy to show to their therapist and board game to keep their engagement with the parent between exercises. 
  3. Be flexible: When plan A doesn’t go accordingly, be willing to change course.  
    • Take the child’s lead and adapt as necessary. Let the therapist guide you in facilitating therapy strategies through real-life reactions and experiences. 
    • Use items in your home to replicate therapy equipment. Ex: Use couch cushions and pillows to create new surfaces for climbing and crashing. 
  4. Make it fun: Be creative and try new things! You may be surprised by new interests and breaking from the same routines. See how much your child can do! 
  5. Make it matter: Use this as an opportunity for your therapist to see your child in your home to incorporate therapy strategies and techniques in your daily routine. Let your therapist see what is important to your child and how to motivate them to achieve their treatment goals. 
    • Ex: A child is experiencing difficulty with mealtime; let the therapist observe seating and position at the table, mealtime structure, and how you communicate to your child during a typical mealtime. Pick a food that is important to your family and ask about strategies to incorporate it into your child’s diet. 
  6. Give your therapist feedback: It may be more difficult to pick up on social cues, be direct about what went well and what could be improved. Share ideas and problem-solve together to plan for the next session.   

COVID Response

As we try to be one step ahead of the COVID-19 crisis and care of your child, we are committed to keeping our programs running. Our tele-therapy services are available to maintain your child’s therapy schedule, help your family navigate this new routine and manage the difficult emotions that may come with it.  We can also help parents that have a concern about their infant or toddler’s development now. There is no need to wait, as the early stages of a child’s life are the most important in their development.

We are pleased that tele-therapy has already helped many children eat a new food, stay active, and improve their regulation and play skills while building a stronger relationship with their caregiver. 

We understand the immense stress of balancing your child’s needs with the demands of work and school while also keeping your family healthy. We are here to ensure that each child and their caregivers have the support they need to adopt this technology and continue therapy progress. 

While much has changed, our commitment to you remains. If you have any needs, we are actively monitoring our main phone number, 630.620.4433 and info@eastersealsdfvr.org. Contact us at any time (please include your full name, child’s name, phone number and email) and a member of our team will return the response within one business day. 

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