Tag Archives: parenting

Executive Functioning Skills: CO-OP Model Expanded

By: Laura Van Zandt, OTR/L

Recently I wrote a blog on how to develop and strengthen executive function skills using the CO-OP (GoalPlanDoCheck) model. I thought I’d take a moment and expand on a very important foundational skill.

“Do with me and not for me”

So often we have great intentions and we do for our children. This isn’t a bad thing; we want our children to succeed. It’s hard to see them struggling. When we do for our children we neglect one very important step in developing their executive function skills. We accidentally take away their ability to plan, prioritize, problem solve, manage their space/time/materials, and reflect.

If we do not expect our children to be an “active participant” in his or her life, then we take away the many opportunities to learn the daily life skills needed for adulthood and the ability for learning how to tackle and master challenges. Involving your child in daily activities and encouraging them to be an active participant builds a strong sense of competency and positive self-esteem. It helps provide the confidence that your child can do many things and learn to ask for assistance when things go wrong.

Getting your child involved doesn’t have to be an elaborate process. Take whatever you are currently doing for your child and give him/her a simple job with the task. If the child is used to doing “nothing” start very small. Any job, regardless of how small (e.g. hold the pillow and place it on the bed while you make the bed, put one or two dishes into the dishwasher, drop a few articles of clothes in the washer, raise his arms to put his shirt on, etc.) is a start.

The best therapeutic opportunities are often right in front of you. There are endless activities (e.g. cooking, laundry, shopping, bathing, etc.) that make up your day.  You can use all your little interactions for many opportunities to develop executive function skills. By taking a little more time, you can  get your child involved around the house. Instead of just doing, slow down and ask for help. You might find your child enjoys helping and you may even start making some new memories together!

Basi Family

By doing with your child, you have the opportunity to break down the task so your child can be successful. In the process your child then starts to learn that a goal (e.g. making a bed) has many steps to the plan (e.g. put on the fitted sheet, do opposite corners, put on the sheet, put on the duvet/comforter, hold open the pillow case and put in the pillow, place the pillows on the bed). When we do the goal sometimes we work with a team (e.g. you and your child) and sometimes we need to adjust our plan (e.g. having them help this time) and sometimes we check throughout the process (e.g. did we get all the pillows?). You should celebrate with your child by “doing it together” with praise, giving high fives, and other gestures of companionship that you and your child share together. In turn, your child feels productive and competent; driving a desire to learn more. Over time your child learns to feel “good” about doing, and the typical daily challenges that are now a major struggle start to melt away. The child becomes more eager to learn, rather than driven to avoid.

I briefly used GoalPlanDoCheck but let’s use the concept in two better examples. Let’s use the first example for getting your children ready for school and let’s use the second example to model tools you use to help yourself get ready. Both ways involve your children.

1) Helping Your Child Get Ready in the Morning

Goal– While first getting your child up in the morning, tell them “It’s time to get ready so our goal is for you to be at school on time.” Use the word goal so your child knows that is GettingReadyforSchoolyour expectation.

Plan– Talk to your child about the steps. “First we need to go the bathroom so we can wash your face and brush your teeth. This usually helps wake you up so you can focus on getting dressed all by yourself. When you are getting dressed all by yourself, mom and dad will be downstairs making your breakfast. You need to eat your breakfast and then grab your lunch so we can get you to school. Don’t forget to double check your backpack and make sure you have everything you need for school or any after school activities.”

Depending on your child and the age of your child, you might simplify the plan. You might use visuals to help your child remember the plan. There are tons of different strategies that can worked within each child’s individual plan that are tailored to his or her specific needs and specific interests to ensure motivation. Depending on your child you might also need to use incentives to help with motivation and time management.

Do– Divide and conquer. Depending on your child’s age, he or she would not be expected to do all the pieces of the plan.

Check– Keep talking to your child. “Did we get everything? Are we on time? What helped us stay on time? What were time robbers?”

2) Modeling Tools You Use to Get Ready in the Morning

Children learn through modeling. This is a great way to begin introducing your child to this concept as well as teach through modeling different strategies.

Goal– While first getting up in the morning and working with your child, talk aloud to them. Talking aloud is not something that comes naturally and must be practiced; however, talking aloud is a great strategy for modeling the development of executive function skills. Tell them “It’s time to get ready so our goal is for you to be at school on time.” Use the word goal so your child knows that is your expectation.

Plan– Talk to your child about the steps; however, instead of listing the steps like we did in the first example, we are going to focus on you and tools that you use. This is important for kids who just seem disorganized, can’t get their arousal level just right, and just need help. Modeling is great to let them know we all use a variety of tools and that tools can be helpful. Here is an example of a conversation you might have while getting ready with your child:

“It’s time to get ready so our goal is for you to be at school on time. I don’t know about you, but mom is feeling really tired today. I have to get up earlier than you so that I can help you get ready. Do you know what helps me wake up so I can focus on getting ready? I start my morning with a shower. Sometimes the feel of the water on my skin wakes me up. Let’s try washing your face since we don’t have time for a shower.”

Notice how in this example, you discussed with your child a tool you use (shower) and provided them with an option to try. This is a great way to model. There are lots of other dialogues you can have with your child to model tools. This was just one example.

Do– Looks the same as in the first example; however, depending on the tool you may or may not be modeling. Do in the example above was telling your child and then providing your child with an example to do together.

Check– Remains the same. In this stage, we are actively involving our child to think and problem solve.

Have fun with it and know that you are working on developing and strengthening your child’s executive function skills. Executive function skills are developmental and must be taught. When working with your child, you are setting a path toward greater independence. Start simple and build gradually.

If your child is not used to doing much, start with a couple of activities a day. Pick a time of the day when you are not feeling rushed and your child is not feeling stressed. This will give you practice in how to guide, assist, and engage your child. Once it starts to feel natural, expand the “we-dos” into many daily activities. Do them together, giving him/her a little part to play, and gradually expanding his/her role to build more competence.

You are an important part in the development of your child. The more you can help your child think about what they do and why, the more they will be able to use that thinking in any problem solving situation. As my other blog concluded, the overall goal is to teach your child how to work through a problem using a planned approach instead of acting impulsively.

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. 

Executive Function Skills: CO-OP Model

By: Laura Van Zandt, OTR/L

GOALPLANDOCHECK.

Executive functioning skills seems like the new ‘buzz’ word for therapists and parents working with children of all ages. Executive functioning skills include the ability to pay attention, recall a series of information, manage your time, be flexible, self-monitor for your emotions and impulses, initiate tasks, problem solve, persist as well as plan, organize, and sequence. One of our former speech therapists, Jennifer Tripoli, wrote a nice blog in August 2014 which you can refer to for more information regarding the definition of executive function skills.

One strategy that I like to teach children is a concept from the Cognitive Orientation to Occupational Performance or CO-OP model by Helene Polatajko and Angela Mandich called GOALPLANDOCHECK.

The CO-OP model is a “client-centered, performance based, problem solving approach that enables skill acquisition through a process of strategy use and guided discovery.” Occupational performance is what we do and how we do things throughout our day. Cognitive orientation implies that what we do and how we do things involve a cognitive process. The approach is designed to guide individuals to independently discover and develop cognitive strategies to meet their goals. That sounds like a lot of executive functioning skill development to me!

The use of self-talk is key with GOALPLANDOCHECK. When we require children to walk us through their plan and teach us their steps by talking aloud, they engablogge in more effective approaches to learning.

When teaching children, we start with the GOAL. We teach the child to understand the word GOAL as being something we are working towards completing. One strategy that has been helpful for visualizing the end GOAL is the concept of “future glasses.” Have the child wear funny glasses or simply make your hands in the shape of glasses. Then close your eyes and visualize the completed GOAL and what it might look like when completed.

The word PLAN implies there are a series of steps we need to do in order to meet our GOAL. To me the PLAN is critical for developing our problem solving skills.

Next we DO our goal.

Finally, we CHECK. The CHECK is really important for developing and strengthening our meta-cognitive skills. It is very important to understand how we can do better next time based on what we did today. CHECK gives the opportunity for feedback control by finding and correcting a mistake before the plan is final. It allows for incorporating flexibility and the ability to shift strategies when the current plan is not working.

KevinThis process helps children strengthen their executive function skills in the areas of working memory to pull from previous experiences, planning and prioritizing steps involved, persisting to achieve goals, and reflecting back by checking in with the plan to see if it was successful. If not, make alterations in order to be successful, eliminate time robbers to help with impulse control, and manage their time. Remember, initially it is about the practice and not the end result. It is okay to make mistakes. We all learn from mistakes.

Parents and family are an important part of the CO-OP approach. The effectiveness of the intervention is greatly increased when everyone is involved. Parents and family help the
individual child to acquire and practice these skills. It also helps them to transfer and generalize the learned strategies into everyday life. By providing explanations as well as guidance and asking questions at an appropriate developmental level, we provide just enough support necessary for the child to be successful. The more you can help children think about what they do and why, the more they will be able to use that thinking in any problem solving situation. The overall goal is to teach a child how to work through a problem using a planned approach instead of acting impulsively.

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. 

Get Your Little One Walking

By: Bridget Hobbs PT, DPT

A child’s first year of life is so full of milestones… first smiles, first solid foods, and the first time s/he sits up on his/her own.  As the first year is coming to a close, many parents desire to see their little one taking their first steps around the time of their first birthday.  The typical window for children taking their first steps is anytime between 9 and 15 months, which is a big spectrum of time.

Below are some things that parents or caregivers can do with their child to help them get walking when they are showing signs that they are ready.

  • Set a good foundation for your baby. Walking involves strength from the entire body, not just the legs.  Believe it or not, creeping on hands and knees is an important milestone to achieve before walking.  Also, climbing over obstacles, such as couch cushions or parents’ legs is another good way to help build a solid core, or base for walking.  You can also help build strength in the core, arms and legs by teaching your child to crawl up steps. Try placing a favorite toy on the landing as motivation.
  • 01_Lucas_Vasquez2After a child learns to pull up and stand at the couch or coffee table, place toys away from their body so that the child has to rotate their body away from the support surface to reach for the toy. This technique will not only help build important rotator muscles in their trunk but will also gradually encourage them to stand with less support.
  • Once your child is standing supported holding onto furniture, have them practice little squat to stand movements. For example, motivate your child by placing a stacking ring at the height of their knees. While supporting them at their waist, encourage them to bend at their knees and hips to pick up the ring and then stand back up to help them place the ring on the stacking toy.
  • When your child is pulling up to stand, cruising side to side along furniture and starting to experiment with standing on their own, they are likely ready to start taking some steps. Hold onto one end of a hula hoop or small ring and encourage your child to hold onto the other side. While facing your child, encourage them to take a few steps while holding onto the ring for support.  You can also use a motivator, such as walking to pop bubbles or to grasp a puff snack as encouragement to get your child to talk some steps.
  • Weighing down a push toy, such as a small shopping cart or ride on toy will provide them the support they need to take forward steps. Often times these toys will move too fast, causing a child to face-plant forward if they are not weighted down, so place a gallon of milk or carton of orange juice in the shopping cart or ride on toy to help with this.

02_Josephine_Huard.jpg_waterIf your child is not showing any signs of pre-walking skills, such as pulling up to stand, walking along furniture or walking with hand held assist, and they are at the age when many of their peers are starting to walk, it’s always good to talk to your pediatrician about possible reasons why they are late to walking.

To learn more about  Physical Therapy and play-based therapy services at Easter Seals DuPage & Fox Valley, visit our website.

 

Back to Sleep: Tummy to Play

By: Cassidy McCoy, PT

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?

TakeThreePhotography_05202010-123
Photo from Take Three Photography

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!

For more information on Physical Therapy and play-based therapy services at Easter Seals DuPage & Fox Valley, visit our website: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/physical-therapy.html

Everyone Sitting at the Table: The Power of Family Meals

By: Emily Mitchell, Easter Seals DuPage & Fox Valley and Northern Illinois University Dietetic Intern & Candidate for Masters in Nutrition and Dietetics

When was the last time your entire family sat down for a meal together? You are an extremely influential role model for your child, and your actions and emotions are essential for your child’s growth and development. Your child learns through experiences and modeling behaviors, so try using meal time as a chance to work towards developmental milestones!

Family Style Meal Service

The environment in which meals are served can impact a toddler’s willingness to try new foods and develop healthy dietary patterns. Family style meals have been shown to be an effective approach in creating an environment conducive to establishing healthy behaviors in the home, as well as in schools and daycare facilities. Most importantly, family style meal service approaches mealtime as a learning experience.

The objectives of family style meal service include:

  • Helping children develop positive attitudes towards nutritious foods
  • Learning to engage in social eating situations
  • Developing healthy eating patterns

myplate_greenChild involvement is integral to the concept of family style meal service, and can be done by allowing children to do the following things:

  • Be the “produce picker” at the store
  • Assist with meal preparation
  • Set the table places
  • Engage in conversation during the meal
  • Assist with clean up

Involvement in meal time may look different for each child based on their developmental abilities. When establishing family meals, it is important that children are not only provided guidance through physical assistance and engaging in appropriate social exchanges, such as taking turns, but are also given age appropriate serving utensils and dishware to establish age appropriate portions.

Meal Time- It’s Not Just About Food and Nutrition!

Again, meal time is not solely about food and nutrition; it also provides parents the opportunity to model social, communication and motor skills. Approach mealtime as a learning experience and remember that meal time serves not only to help children develop positive attitudes towards nutritious foods, but also learn to engage in social eating situations, and develop motor skills.

In order to hone in on social, communication and motor skills, involving your child in meal time is key! Conversations during meal time provide an opportunity to enhance family connection and establish relationships among all members of the family. It is a chance to share information or news about your day.

Maggie_1.jpgBenefits and Barriers to Family Meals

Family meals have been shown to foster happy, well- adjusted kids. Research has shown that family meals have many benefits, including:

  • Opportunities for modeling healthy behaviors
  • Increase autonomy in children
  • Enhance communication and social skills
  • Heighten family connectedness
  • Develop motor skills
  • Encourage nutritious meals

Despite the many benefits of family meals, it can be trouble to do because of, child behavior problems, scheduling difficulties, and lack of self-efficacy in meal preparation.

What About My Child on Tube Feedings?

How do you involve everyone in the meal? Just as children consume food orally, your child on a tube feeding can use family meal time to socialize, interact, and learn. Have meal time conversations that are about more than the food. Look beyond the calorie nourishment of meal times and include your child receiving tube feedings in meal time, so they can receive the many qualities of meal times.

fun-with-food-035What is So Powerful About Meal Time?

The real power of meal time is the interpersonal quality. Kids like eating with their families, so allow for some fun! It is understandable that meal time may be frustrating at times, but try to make it as positive of an experience as possible. Dinner may be the one time during the day that a parent and child can share a positive experience—a yummy meal, a joke, or a story. Many children strive for autonomy, so as discussed previously, involve your kids in meal time and allow for learning and laughter! These special moments created at the table help gain momentum for your child’s development away from the table.

Your challenge–schedule time spent at the table with your family into your day!

If you find your child has nutrition problems including failure to thrive, obesity, poor feeding skills, sensory disorders, and gastrointestinal disorders or others schedule a nutritional evaluation with Easter Seals DuPage & Fox Valley today. Learn more at eastersealsdfvr.org/nutrition.

Motivation Comes From Seeing Your Future Self

By: Jessica Drake-Simmons M.S. CCC-SLP

We all have a range in abilities of executive functioning.  Kids and adults alike can struggle with organization, memory, focus, managing time, initiating a task and completing a task.

Being able to visualize the future is an imperative skill for moving from event to event and showing up on time with the needed materials.

Some of our kids who struggle with executive functioning may seem distracted, disorganized and struggling to keep up with the pace of the day.

Additionally, some of these kids can be perceived as being unmotivated.   They might be smart kids that simply don’t appear driven to work up to their potential.  Executive functioning guru, Sarah Ward, asserts that these kids have difficulty imagining their future emotions.  They don’t intuitively imagine what they will feel like or what they will look like when they complete a task or achieve a goal.

first-blog-picturesecond-blog-pictureJorge on bike.jpg

What I need to look like now.                                   So that I can look like this later.

We want kids to be able to see the future, say the future, feel the future and plan for the future.  So how can we facilitate this skill of ‘future imagery thinking’?

  • Have your child make an image by helping them talk through the following:
    • What will the environment look like?
    • Who else do you see being there?
    • What will I look like?
    • What will I feel like?
  • Ask questions that encourage future imagery thinking.
    • Ask:  “When you walk into class tomorrow, what do you see yourself handing to your teacher?”
      • Instead of:  “What do you have for homework tonight?”
    • Ask: “What would you look like if you were standing by the door, ready to leave for soccer?”
      • Instead of: “Go get ready for soccer.”

Making a mental movie of the future requires us to actively think through the necessary steps in order to complete a task.  It enables us to envision and play a ‘dry run’ of a task without the risk of error.  Seeing the future helps us to persist through the present challenge in order to achieve our goals.

To learn more about Easter Seals DuPage and Fox Valley programs, visit eastersealsdfvr.org.

 

Featured image by: Lauren Sims

Getting Ready For Fall by Teaching Your Child to Dress a Coat

By: Maureen Karwowski, OT

As the leaves begin to turn, it will soon be time to break out those sweaters and coats. This is a great time for your child to practice dressing their coat independently.

As an occupational therapist, I am always looking for ways to help my clients reach their maximum independence. As children become more independent, they develop more confidence and are more likely to try other challenges as well. For my clients that have fine motor difficulties, practicing dressing skills is a natural and routine way to help them develop their fine motor abilities.  Independence with dressing occurs one step at a time, so we can start with dressing a coat as the first step.

Once a child is able to stand securely, or sit securely if they have postural difficulties, it is a good time to start. Here is the “over the head” method that I would start with:

  1. Place the coat on the floor or a low table
  2. Lay the coat flat with the inside facing up
  3. Stand facing the top or collar of the coat
  4. Bend over and place the arms in the sleeves
  5. Lift the entire coat up and overhead
  6. When the arms come down you are all set!

Zipping up a coat requires more precise fine motor skills and strength. I would start by having the child zip up the coat once you have engaged the zipper. When assisting your child with any fasteners, always stand behind them to give them perspective on how their hands should work. You can use a zipper pull to make it easier for your child to grasp the zipper. A quick online search yields many cute options, but you can also use a key ring that you have at home. A magnetic zipper is also a nice alternative while your child is working on manipulating a zipper. Several clothing companies offer this.

This slideshow requires JavaScript.

It is important to assist your child, while not jumping in too soon. Be sure to leave extra time, and focus on one step at a time. Once they are independent with this, then you can focus on promoting another dressing task. Good luck and stay warm!

To learn more about Easter Seals DuPage & Fox Valley occupational therapy services, visit eastersealsdfvr.org.

Occupational Therapist Recommended iPad Apps

By: Laura Bueche, MOT OTR/L

No one can deny the powers of the iPad. The back lit animations, sound effects and interactive games make apps a great tool for kids to learn. Kids and adults are drawn to the technology?

The American Academy of Pediatrics (AAP) recommends limiting the amount of screen time a child has to “high-quality content.” They recommend children and teens should engage with entertainment media for no more than one or two hours per day and that television and other entertainment media should be avoided for infants and children under age 2.

But what games or content are high-quality? As a pediatric occupational therapist, I use iPad apps during therapy as a therapeutic tool to help kid’s develop skills.  Below are my favorite quality iPad apps.

Fine Motor Skills

Dexteria

 

Dexteria By: Binary Labs, Inc.
Price: $3.99

Dexteria turns your iOS device into a therapeutic tool that improves fine motor skills and handwriting readiness in children and adults.

dexteria jr

Dexteria Jr. By: BinaryLabs, Inc.
Price: $2.99

Set of hand and finger exercises to develop fine motor skills and handwriting readiness. The activities are specially designed for kids age 2-6.

dottodot

Dot to Dot Numbers and Letters Lite By: Apps in My Pocket Ltd By Apps in My Pocket Ltd
Price: Free

Trace through dot-to-dot puzzles for visual motor skills and visual tracking.

bugsandbuttons

Bugs and Buttons By: Little Bit Studio, LLC.
Price: $2.99

18 mini-games and activities that make learning fun. Count colorful buttons, recycle with marching ants or dainty ladybugs, recognize letters, solve bug mazes, and more!

 

Letter and Number Formation

letter&number2 letter&number

Letter School By: Letterschool Enabling Learning B.V.
Price: $4.99

Play to learn how to write all letters of the alphabet: abc – xyz and the numbers 1-10 with LetterSchool.

letterworkbook

Letter Workbook Home Edition By: BigCleaverLearning
Price: Free

Letter Workbook is an interactive educational app which teaches toddlers and children how to form and write letters. Through the simple, interactive guide children will learn how to write their ABC, improve vocabulary and have fun along the way!

myfirst number trace

My First Number Trace By: Neutre
Price: $1.99

Easy tracing for little fingers. Trace letters 1-10.

iwritewords

iWriteWords By: gdiplus
Price: $2.99

iWriteWords teaches your child handwriting while playing a fun and entertaining game.

 

Visual Perception

littlethings

Little Things By: KLICKTOCK
Price: $2.99

An innovative seek and find game. Search colorful collages built from thousands of little things. Randomized searches ensure a different game each time you play.

rushhour

Rush Hour Free By: Thinkfun Inc.
Price: Free

The original sliding block Traffic Jam puzzle, works on visual perception, problem solving, and attention.

 

visual attention
Visual Attention Therapy By: Tactus Therapy Solutions Ltd. Price: $9.99

Visual Attention Therapy helps brain injury and stroke survivors, as well as struggling students, to improve scanning abilities. It also helps rehab professionals to assess for neglect and provide more efficient and effective therapy for attention deficits.


Cause and Effect Apps

peekaboo

Peekaboo Forrest, Barn, or Fridge By: Night & Day Studios, Inc.
Price: $1.99

If you see something moving, tap on it to find out who it is!

ilovefireworks

Ilovefireworks lite By: Fireworks Games

Price: Free

Create beautiful fireworks display by easy tap operation! Touch on the screen, you immediately see breath taking fireworks in 3D graphics and real sounds.

touchofmusic

Touch of Music By: gamegou

Price: Free

Enjoy the freedom to play songs at your own beat while never missing a note.

 

Self Care Skills 

idohygiene

IdoHygiene By: C.E.T – THE CENTER FOR EDUCATIONAL TECHNOLOGY
Price: Free

Learn the most common personal hygiene daily activities (teeth brushing, shampooing , hand washing, toilet training, taking a shower , public bathroom, etc.)

t-rex

T-Rex Toothbrush Timer By: PCAppDev Limited
Price: $0.99

Encourage your kids to brush their own teeth properly by following Dino brush his teeth!!

To learn more about Occupational Therapy at Easter Seals DuPage & Fox Valley visit eastersealsdfvr.org.

Gross Motor Play- Why Some Kids Won’t Participate

By Laura Znajda, PT, C/NDT
Manager of Community Based Therapy and Continuing Education

Summer is the ideal time for outdoor play, and children who love to run and climb are in their element. But children with very mild developmental challenges– or even no diagnosed problem at all— can have a great deal of difficulty learning new motor skills and keeping up with their peers on the playground.  Some children are mistakenly thought to be “clumsy” or “lazy” when they don’t try the advanced motor skills other children their age are mastering.

Physical and occupational therapists sometimes receive referrals to work with these children to strengthen their bodies so that they can gain skills more easily and keep up with their peers.  However, there is more to motor skills than just strength.  Pediatric therapists must analyze a child’s performance and consider all factors that might be impacting their success:Hannah_T

Flexibility
:  We all need normal range of motion in our joints to perform daily tasks, but outdoor play can require extreme ranges of movement as kids stretch their limbs to make that great play of the game or to access new parts of a play gym.  A restriction in range of motion at the hip or shoulder might make climbing the slide ladder difficult.  A neck range limitation could make it challenging for a child to scan the playing field for a teammate that is open for a pass.

Motor Planning:  Paraphrased from Jean Ayres, PhD, motor planning is defined as the act of planning movements inside the brain to complete a series of actions in the proper sequence.  Before a child even starts to move, the sequence of action is planned out in the brain.  When the child lacks experience with a particular skill, like pumping herself on a swing or hitting a ball with a bat, she might hesitate in order to give her brain time to make a plan for this novel task.  Typically, the time it takes to get started will decrease as the task becomes more familiar, but for some children this motor planning component does not come naturally and needs assistance.

Emmett_T.jpgBalance:  Children need to be able to balance on one leg long enough to lift the other leg to a raised surface or to kick a ball.  Even more importantly, they need dynamic balance—that is, control of their bodies while they are moving and balanced on one limb in order to reach out to the side to catch a baseball or make a soccer save.  A child with balance difficulties will seek out stable objects to hold when he has to lift a foot for any length of time or will avoid these activities altogether.

Coordination:    According to CanChild, a research center at McMaster University that organizes clinical  research concerning children with developmental conditions, coordination is a sequence of muscular actions or body movements occurring in a purposeful, orderly fashion (smooth and efficient).  We often think of coordination as the ability to use both sides of the body at the same time.  We need coordination to make the same movements with both arms and legs when we do exercises like jumping jacks.  And we need coordination to do different things with each body part, but all at the same time, such as dribbling a basketball while walking or running.  A child with coordination difficulties might need these advanced motor skills to be taught in a more graded manner before she can master them.Robbie_T.jpg

Motivation:  It might seem obvious that a child must be interested and motivated in an activity in order to be successful with it, however this important component of motor skill performance is sometimes overlooked.  Although research is inconclusive as to exactly how many repetitions are needed, we do know that a new skill requires at least hundreds of repetitions in order to become proficient.   If a child is not motivated to play a particular sport, he will not have the determination to practice a skill over and over and will not see the success that comes from that critical repetition.

Finally, strength is important. Just as necessary as all of these motor skill components; but not the only factor to consider when a child is hesitant or unsuccessful with outdoor play.

Easter Seals DuPage & Fox Valley therapists are expanding their ability to get to the bottom of why children don’t participate in outdoor play and develop new strategies to help them through a continuing education course taught by Lezlie Adler, OTR/L, C/NDT and Jane Styer-Acevedo, PT, DPT, C/NDT on September 22-23, 2016 at our Villa Park center.  Registration is open to all therapists at:  http://www.eastersealsdfvr.org/ce

References

Can Child, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada L8S 1C7  www.canchild.ca

Ayres, A. Jean, Sensory Integration and the Child, Western Psychological Services, 2005.

A Checklist for this Year’s IEP

By: Sharon Pike, Family Services Parent Liaison

As one of the Parent Liaisons at Easter Seals DuPage & Fox Valley, I have experienced many years of not only my own children’s IEP’s, but countless families from our centers.   Here are some strategies that have helped our families feel like a true member of the team and confident that this year’s IEP is a well written plan that will meet their child’s needs.

Prepare for the meeting

  1. Make a list of your child’s strengths and needs. Bring it with you to review during the meeting to insure they are covering things that are important to your child’s success in school. Think about and write down strategies that work at home and with your private therapist to share with the staff.
  2. Know what the law requires. Section 614 of the Individuals with Disabilities Education Act (IDEA) sets out the process and elements of what needs to be explored to develop and revise and IEP.  States and local school districts add their own policies on top of what is required under the federal law. That being said it doesn’t mean you need to know the letter of the law.   Bottom line… the more you know and understand the easier the process is.
  3. Never attend this meeting alone. It’s important that you and your spouse attend if possible.  If not then ask a grandparent or a friend. Their role is to be support for you and another set of ears!  Often at these meetings we can get stuck on something one member of the staff said and miss important information.  Make sure you inform the school that you are bringing someone with.
  4. Start the meeting with a positive statement about your child even if you’ve had a difficult period there is ALWAYS something positive to say… he has the best smile, she is caring and kind, he loves other children!
  5. When talking to the team, focus on your child’s needs and NOT your wants! Take the I out of IEP. Avoid, I want him to work on, I want her to be in this class, I think she needs….  Rephrase everything. He needs to have these supports in order to be successful. She needs to have sensory break before being expected to do table top activities, as it helps her focus.  The goal of special education is to meet the child’s needs, not the needs of us parents.
  6. Placement is not the first decision. This is determined after the team has decided what services and supports are needed.  This is hard; as it is often the first thing you want to know!
  7. 01_Mason EsquivelTrust your gut. If a piece of the IEP doesn’t feel right, and you can’t reach an agreement with the school, make sure it is documented that you do not agree.  Remember, just because you disagree doesn’t mean it will be changed.  The whole team has to agree to change it.  But I always say, ask for the moon and hope for the stars!
  8. Think about your child’s future! Aim HIGH.  Don’t wait until high school to start planning for what your child can do as an adult.  Every skill your child achieves in elementary school will help him or her be an independent adult.
  9. Establish a clear and reasonable communication plan with the school and your child’s teacher. Stick to the plan.  You and the school are partners in your child’s development and learning.
  10. Remember the IEP is a fluid document and can be amended at any time by requesting another IEP meeting.

After the IEP meeting

Pat yourself on the back for another successful IEP under your belt.

Easter Seals DuPage & Fox Valley Family Services provide information, education and support that address the concerns and stressors which may accompany having a child with special needs.  Our parent liaisons are highly trained parents of children with special needs.  They provide parents and caregivers with support from the unique perspective of someone “who has been there” in both informal one-on-one and group settings. For more resources and information click here.