Dealing with Sensory Overload

By: Megan Fickert, Therapy Aide

What is Sensory Overload?

Simply put, sensory overload is when one’s senses become overwhelmed to the point that a person is negatively impacted. Sensory overload can affect anyone but is particularly common among those with developmental disabilities like ADHD or autism that cause difficulty with filtering external input that other people might find perfectly tolerable.

Sensory overload can be a physically painful experience. As a small child, if I was outside and someone a block away was mowing their lawn, I would crouch low to the ground and clasp my hands over my ears. I used to run out of the bathroom in elementary school because of the automatic toilets, and to this day, I still have to cover my ears whenever I flush!

To an observer, it will often be obvious what is happening to a person experiencing sensory overload, but other times people may simply appear distracted or disengaged from their surroundings or may lash out in frustration instead.

For many disabled people, sensory overload becomes an everyday challenge. Let’s go over some ways of dealing with it.

Prevention

The ideal scenario is preventing instances of overload from happening in the first place. This means being mindful of your surroundings and planning ahead. Know how certain stimuli affect you or others. Have an escape route in mind and a way to communicate your needs. Avoid situations you know will lead to sensory overload if you can.

But of course, life doesn’t work seamlessly and there will always be unexpected scenarios that bring on overload. Here is how you can help yourself or someone else when it arises.

1. Remove Yourself

If possible, one of the quickest ways to handle overload is to remove oneself entirely. If you begin to feel overwhelmed, excuse yourself or ask someone to help you get out of the area. If you are assisting someone else, keep an eye on their reactions and give them chances to escape their environment if it seems like they have become overloaded.

Some adults and children may not have the self-awareness or communication skills to let others know they have become overloaded, so check in with them often when you are in especially stimulating or busy environments, and remember to take breaks even if sensory overload hasn’t occurred yet.

2. Block Incoming Senses

If leaving is not an option, the next best thing is to block stimuli. Wear earplugs or headphones if sound is an issue. Cover your eyes, look to the floor or even hide under a blanket to block visual input. Plug your nose to keep smells away. Have alternative clothes in case you become irritated by tags, seams or textures.

3. Ask for Help

In some cases it may be possible to ask for help. Admittedly this can be a scary task and isn’t always feasible, but some venues may be able to accommodate your needs if you speak up! Ask for the volume to be lowered or lights to be turned down, ask to be seated away from others. This is often best done as part of prevention, but sometimes it’s necessary to ask for help on the spot, too.

4. Override External Input

When it comes to sensory overload, sometimes the most overwhelming part is experiencing excess stimuli that we have no control over. To counter this, it might help to create your own stimuli to focus on instead. (Be mindful that in public scenarios, this might not be possible if it will be disruptive for others). 

Stimming, or self-stimulatory behavior, is often a natural reaction to sensory overload. If external sound is bothersome, listen to music or make sounds of your own to focus on instead! Draw a picture or focus on a specific object to drown out other visual input. Flap your hands, wiggle your toes, or stomp your feet to express control over how your body feels. Use a weighted blanket to control proprioceptive input.

Basic Sensory Overload Kit

Here is a list of some good items to keep on hand for situations when sensory overload may be expected. Because different things work for different people, make sure to customize your own kit with what works for you based on the situation and circumstances.

• Ear protection (headphones, earplugs)
• Eye protection (sunglasses, hats, eye masks)
• Hand fidgets (tangles, stress balls, marble mazes, etc.)
• Chewable fidgets (handheld or wearable “chewelry”)
• Weight/pressure tools (blankets, vests, compression garments)

Sensory Overload Summary

Ultimately, how one deals with sensory overload will greatly depend on the individual and the situation, but these are the basics on how to help yourself or others when faced with it in daily life.

Remember that instances of overload are inevitable, but being proactive and utilizing tools at your disposal can minimize these unpleasant experiences for yourself or someone you care about.

To learn more about sensory processing disorder and how we can help, visit: https://www.easterseals.com/dfv/our-programs/sensory-processing-disorder.html

How to Ensure Greater Videoconferencing Success for all Hearing Abilities

By: Karyn Voels Malesevic, AuD, CCC-A, Audiologist & Manager of Audiology

Living under the conditions of COVID-19 has many of us becoming more reliant on Zoom, Microsoft Teams, or other video conferencing apps than we ever thought we would be. Between conference calls for work, children learning at home, or catching up with friends or family, it’s apparent that these programs are here to stay. Using these video conferencing tools for an individual with a hearing impairment can be challenging. Below, I have a few headphone and room setup recommendations to make the experience successful for all. 

Considerations for those with Hearing Impairment

Using headphones with hearing aids

If you are the person with hearing loss and you need to videoconference, built-in speakers and mics are generally not going to cut it. When determining what headphones are right for you as an individual with hearings aids, you first need to recognize what type of hearing aids you use. Hearing aids are separated into two main categories, behind the ear (BTE) and in the Ear/Canal (ITE/C) hearing aids. Some ITC aids fit entirely in the ear canal and are known as Completely In the Canal or (CIC). These are the smallest and least visible hearing aid types. 

ITE/C and CIC hearing aids may give you the most flexibility when finding a pair of headphones. According to Audiologist, Brian Fligor from a consumer reports article, “BTEs are especially finicky because the microphone, which picks up outside sounds that are then processed by the hearing aid, is outside the ear canal.” “If you have a headphone that doesn’t sit up and over that, then you’re not going to pick up any sound through the hearing aid itself.” In either case, there should be an option that works for you and your specific style of hearing aids that can be found after some trial and error. 

According to Fligor “the key is to find a pair that’s comfortable and holds the headphone speakers a reasonable distance from the hearing aid microphone in order to avoid feedback. Fligor says a distance of 1 centimeter, if not a little more, is usually a safe bet.” It’s also important to note that some people who wear ITC aids may also comfortably wear on-ear headphones, which are typically lighter and more portable. For some users who wear CIC aids, which are the smallest, they may even be able to wear earbuds depending on the fit of their hearing aid. The end process will likely come down to experimentation as each individual, and their preferences will vary. 

The articles below share more information on the topic of hearing aids and headphone’s and will provide recommendations for specific headphone models.

https://www.consumerreports.org/hearing-ear-care/headphones-and-hearing-aids/

https://www.healthyhearing.com/report/52907-Using-headphones-with-hearing-aids

General Tips for Hearing-Friendly Video Conferences

Setup and Communication Style

Photo by Julia M Cameron on Pexels.com

The Hearing Journal addresses the importance of a successful video conference setup and recognizing communication styles. As a bonus, many of these tips help foster a better video conferencing atmosphere for everyone, not just those with a hearing impairment. The authors share:

1. Secure a strong internet connection and a reliable visual setup to enhance non-verbal communication. Turn on your camera and sit in a well-lit space to brighten your face and avoid backlighting, such as light shining through a window behind a workstation. Sit reasonably close to the webcam with the top of the head to your elbows seen on camera.
2. Foster high-quality audio and eliminate background noise. Use a high-quality microphone, headset/microphone combo, or earbuds. When you’re not speaking, put your microphone on mute to reduce background noise.
3. Practice respectful communication etiquette. Speak in turn and state your name before speaking. Project your voice succinctly and articulately, and avoid fillers such as “so” and “um.” People with hearing loss have a hard time keeping up with spontaneous discussions and details, so try not to sway from the agenda and type your questions or clarifications in the chat feature of the videoconferencing tool you are using.
4. Suggest these communication facilitation tips to the meeting host: Publish and stick to an agenda, request that questions, links, contact information, and other logistics be typed in the chat box that is visible to all participants, inform participants when the topic has changed, and give everyone, including the person with hearing loss, time to process the information and formulate a response.

For individuals with hearing impairment, adding real-time closed captioning can make a tremendous difference in their video conferencing experience. Many videoconferencing providers such as Google Meet, Microsoft Teams and Skype now include an automatic live captioning feature.

Your hearing needs are important and our Audiology Department can help. Hearing loss is one of the most common conditions detected in infants, children, and older adults. We welcome people of every age, from newborns to adults, and offer a wide variety of services from basic hearing tests and evaluations to hearing aids and hearing aid fittings, all using leading-edge technology. For more information on our audiology services for all ages and help for hearing aid , please visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/hearing.html.

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:

• Segal, R. (2004). Family routines and rituals: A context for occupational therapy interventions. American Journal of Occupational Therapy, 58, 499–508.
• And Next Comes L Website link: https://www.andnextcomesl.com/2018/07/free-social-stories-about-transitions.html
• The Many Little Joys Website link: https://www.themanylittlejoys.com/gift-guide-our-favorite-board-games-for-kids/
• A Day in Our Shoes website link: https://adayinourshoes.com/free-printable-visual-schedules-for-home-and-daily-routines/

Chores and Executive Functioning

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

People are not leaving their houses right now and you know what that is resulting in?  A need for lots of cleaning and organizing!  This doesn’t have to be a solo effort though!  Maybe we can embrace this unique opportunity, where we are being asked to be our children’s teachers, to show our children some new things we don’t normally have time for in everyday life.

Research has found that one of the best predictors of a young adults’ success was whether one participated in household tasks when they were young.  Chores help kids have a “pitch-in” mindset, which is an invaluable skill throughout the lifetime.  In the book, 50 Tips to Help Students Succeed, Marydee Sklar describes the executive functioning skills that are developed when completing chores including:

• Time management
• Delaying gratification
• Planning
• Prioritizing
• Problem-solving
• Focus and goal-directed behavior

Here is an idea of some of the chores your child might be ready to do by age.  The level of assistance a child may need will vary.

Age 2-3: This is a magical age in which your child is so enthusiastic in their desire to  “help”! The problem is that “help” feels like anything but help!  However, it appears that cultures that embrace and expect children in this age group to participate in household work raise children that are willing and proud contributors to household chores.

• Put toys away
• Throw garbage away
• Put dishes in sink
• Help set the table
• Put dirty clothes in the hamper
• Dust the baseboards
• Fold rags, washcloths and dishcloths

Ages 4-5:

• Make the bed
• Feed the pets
• Pick up toys
• Water the plants
• Wipe cabinets
• Put away dishes they can reach
• Clear and clean table after dinner
• Make easy snacks
• Wipe down doorknobs
• Match socks

Ages 6-7

• Sweep the kitchen floor
• Empty the dishwasher
• Sweep the hallways
• Mop the kitchen floor
• Organize the mudroom storage area
• Make a simple salad

Ages 8-9

• Clean room
• Bring in the empty garbage cans
• Put groceries away
• Clean out the car
• Clean room
• Wipe bathroom sink and counters
• Sweep the porch
• Hang, fold and put away clean clothes
• Make scrambled eggs
• Bake cookies

Ages 10-11

• Clean the toilets (inside and outside)
• Wash your own laundry
• Vacuum
• Sweep the garage and driveway
• Wipe down the counters
• Clean the kitchen
• Make a simple meal

Ages 12+: For this age group, help them be proactive in recognizing what needs to be done and initiating a plan for how and when to do it.  Work side-by-side on house projects with them. 

• Clean the garage
• Mow the lawn
• Wash the car
• Mop the floors
• Wash windows
• Clean bathroom
• Help with simple home repairs
• Cook a complete meal

Tips for success:

• Teach the skills- Don’t expect them to learn it on their own.  Break down the task into small steps.
• Help them come up with organizational systems for their belongings that they can maintain with little help from you.  Have written labels or pictures to assist in sorting items in different boxes.
• Take a picture of what their clean room (or other designated) area looks like.  Encourage them to match the picture when their chore is complete.
• Give them some control, even if that means it’s not done the way you would prefer. 
• Assist them in thinking through when they will have time in their schedule to do their chores. 
• Help implement designated chores into daily routines. 
• Schedule work time and break time.
• Help them recognize how long a chore should take to complete in order to maintain their focus to the task and motivation for completing it in a timely manner. 
• Make it fun! 
  • Play music
  • Make it a race or competition
  • Create a chore chart or list which will assist experiencing a sense of accomplishment as they complete their chores
  • Sometimes incentives might help!
  • Have everyone completing chores together

Stay home, stay well, embrace the ones you are socially isolated with and relish in those chores! For more information on Easterseals DuPage & Fox Valley, visit eastersealsdfvr.org.

Top Developmental Toy Ideas

By: Laura Van Zandt, MS, OTR/L and Sarah Peabody, Physical Therapist

Play is an essential piece to optimal child development as it contributes to the cognitive, physical, social, and emotional well-being of children. Walking through the toy aisle can be overwhelming, but it is important to choose a toy that is age-appropriate, promotes healthy development, and encourages positive behavior. View our favorite holiday toy selections below!

Gifts for Infants:

• Activity mat – Activity mats are great for promoting tummy time. Some have mirrors attached which helps the infant to lift his or her head up and engage in the mirror. Tummy time should start as early as possible for 3-5 minutes a couple times a day, building up the length and duration as the baby grows. Tummy time is essential to help your baby build the strength needed for rolling over, sitting up, crawling, and walking.
• Black and white toys – For young infants (birth – 3 months), toys with high contrast are the most appealing, as their vision has not adapted to seeing colors yet. Around 5-6 months of age, bright and colorful toys are appropriate as infants will likely be able to see the full spectrum of colors.
• Mirrors – These are a great resource for visual engagement.
• Colorful rattles, O-ball, a textured toy – Toys that children can reach for and grasp are great to promote fine motor development. Toys that appeal to multiple senses are ideal for infants and promote positive sensory development. Infants enjoy exploring the feeling of new textures.

Gifts for Toddlers – The toys listed below help kids learn to understand patterns, problem solve, and develop competence and confidence.

• Push toys – Ideal for the early toddler/young walking stage (bonus – with the one linked here, you can put objects into the push toy to weigh it down. Heavy work is great for building core strength!)
• Sorting and Nesting Toys
• Blocks, LEGOS, Magnetic Sets – Open-ended toys like these can be used in a variety of ways. Kids love to take things apart and add to structures at this age, and these toys will extend into the preschool years and beyond. This is also a great way to incorporate problem solving skills and provide opportunities for adult interaction into play.
• Hand puppets – These are a great way to encourage interaction and communication in the young child.
• Shape Sorters and Simple Puzzles– Shape sorters and early inset puzzles are great for toddlers. Interlocking puzzles of various sizes can be a great interactive toy for learning about all kinds of things. Look for puzzles that have large knobs for younger children or those that struggle with fine motor skills.  Puzzles are also great to help children develop their visual perceptual skills and become better problem solvers.

Gifts for Preschool Age Children:

• Play sets – Play sets with little people, dolls, animals, etc can expand a child’s language and communication skills and help them make sense of the world by imitating adult behavior and encourages imagination.
• Mini trampoline, scooter, tricycle – Improve a child’s gross motor skills and helps release their boundless energy.
• Easel, markers & crayons – These are another great way for a child to use their imaginations and develop their fine motor skills.
• Floor puzzles
• Simple dress-up costumes – When kids play dress up, their imaginations really get to blossom. Instead of buying a specific cartoon/movie character dress up costume, buy a generic tutu or princess dress where a child can be multiple different characters all in one outfit.
• Games- The nice thing about games is you can play them in a variety of ways. You don’t have to be stuck to the traditional rules. You can even use the games in pretend play. Here are just a few names of popular games used in therapy sessions: Pop the Pirate, Pop The Pig, Sneaky Snacky Squirrel, Scatterpillar, Jenga, Spot It, Hullabaloo, I Can Do That, Connect Four, Thumbs Up, Tricky Fingers, Boggle, Rush Hour, Gravity Maze, Quirkle, Blokus, Go Fish, Chutes and Ladders, and Dragon Dash.

Gifts for Elementary Age Children:

• Dolls
• Books – Reading will help advance a child’s language, vocabulary,  and social skills, while helping build coping feelings, and building their self-confidence levels.
• Adventure/Building Toys – These are great for problem solving, critical thinking, and imagination.
• Board Games – Don’t forget about the classic board games such as Sorry or Trouble that promote social interaction, turn-taking, and inclusion!
• Bike

Never forget, a trip to the museum, theater, or special exhibit is a great gift too! Experiences can never be replaced with toys and the trip will stay with a child for a long time. Capture them with your phone or camera and you can pull them out to talk about and connect on a later date.

For more ideas, visit our Amazon wishlist that shares suggestions for multiple age range and child need. Most of the toys listed can be adapted in some way or used by children of all abilities.

If shopping online, remember AmazonSmile is a website operated by Amazon with the same products, prices, and shopping features as Amazon, but the difference is that when you shop on AmazonSmile, the AmazonSmile Foundation will donate 0.5% of the purchase price of eligible products to the charitable organization of your choice. Please choose Easterseals Dupage & Fox Valley to help support our cause.

We wish you a Happy Holiday and New Year!

General Tips for Selecting Developmental Toys for Children

By: Laura Van Zandt, MS, OTR/L and Sarah Peabody, Physical Therapist

It’s the most wonderful time of the year! Time to decorate your home with seasonal decorations, listen to cheerful holiday music, start baking lots of yummy goodies, spend time with friends and family, and shop for the perfect holiday gifts. This time of year can bring merriment and stress! Especially when considering gift ideas for children.

If you are buying a toy for a child, it’s important to select something that is based on his/her individual need. Every child is unique. Purchasing a toy for a child with special needs involves taking into consideration the child’s unique developmental profile.

Children who lack fine motor skills often have trouble doing things with their hands, like holding a crayon, so they might enjoy toys with large knobs or big levers that will enable them to grasp them more easily. Children with social learning difficulties or sensory processing difficulties might prefer toys that offer movement or heavy work.

Children with physical disabilities might enjoy toys that have buttons and don’t require a lot of fine motor manipulation. They might also enjoy more arts and crafts that allow them to just move their arms without having to worry about holding onto something.

Choosing a toy that is age-appropriate, promotes healthy development, and encourages positive behavior works best. Use these tips below to help guide you for buying gifts for your child, a niece or nephew or other child:

General Tips for Selecting Developmental Toys for Children:

1. Spanning multiple age ranges

Finding a multipurpose toy that spans multiple age ranges is a great investment. Toys that are meant for several ages and stages of childhood will be kept around and cherished for a long time.  For example, this Shape Sorter, can be used in late infancy as you place the shapes in and out of the box with the lid open. As your child grows into the toddler stage and enhances their fine motor skills, he or she will learn how to manipulate the shapes and place them in the appropriate spot. You can then incorporate colors, shapes, etc. all into one piece as they advance even more. Another example is magnetic letters. A child can use these at a young age to learn letters and sounds and as they grow into elementary years use them together to make words.

2. Be cautious of age recommendations

Many toys have a suggested age range based on the safety and developmental appropriateness for a child. These recommendations are based on the developmental abilities of an average child and may serve as a starting point for you when selecting a toy for your child. A toy should be challenging, but not frustrating. Likewise, if a toy is too simplistic and beyond your child’s abilities, he or she will quickly lose interest. Children learn and grow at various paces, and what might be an appropriate toy for one two-year-old child may not be for the next.

3. Promoting Exploration and Imagination

Research has found that toys that do “too much” don’t encourage children to use their imaginations. Stuffed animals that talk and sing only prompt the child to press a specific button which takes charge of the play scheme. Instead, look for a toy like blocks. Blocks can be stacked up to build a tower, knocked down by a dragon, lined up to make a city, the list goes on and on. The more your child has to problem solve and use his or her imagination, the more your child will learn through play.

4. Think, Move, and Interact

This generation loves to be entertained with screens. Instead of getting that Ipad or other video console, look for toys that provide opportunities for cooperative play that encourage the development of social skills and positive behaviors like taking turns. Board games are a great example!

5. Sensory Considerations

Toys that are tactile or visual can often help improve how a child processes the information. Music, varying textures, flashing lights, and colors can all improve the sensory appeal to your child. It is important to know the needs of your child because what is appealing for one child may be overstimulating for the next.

6. Promoting Inclusion

Toys that promote groupwork and peer interaction with other children are great to promote social skills and improve self-esteem and overall quality of life.

7. Think outside the box.

Toys don’t always have to be used in the conventional manner. For example, that food puzzle might be a little hard for your child to sit still and focus to complete, however, maybe your child would be motivated to find the pieces hidden in a tactile bin or exploring the house on a gross motor adventure to find the food. For children with physical disabilities, many battery operated toys can be adapted for switches. Check out this blog for directions and this link for purchasing battery interrupters.

If you child is younger, can you use that ring stacker to look through the circles together at each other. Or maybe the rings fit on different body parts. If your child is older, think about using the toys within movement activities.

8. Will the child make memories with it?

Giving experiences is becoming a new, more popular trend (for multiple reasons!). Taking time to explore local attractions can create long lasting memories and even new post-holiday traditions. Most businesses and even public libraries offer gift certificates to local attractions. This is a great way to really personalize a gift for your child.

9. Fun!

Last but not least, make sure the toys are engaging and fun. Do not force a toy upon a child. If they appear not interested in a certain toy, leave it for a few days and re-introduce it at another time. Keeping the toys fun will ultimately make the learning fun for your child.

Visit this blog next week, for more of our specific toy recommendations! You can also search our previous blogs for each year’s toy recommendations like here and here. Happy Holidays! For more information on Easterseals DuPage & Fox Valley visit eastersealsdfvr.org.

 

Preparing for Halloween

By: Laura Van Zandt, MS, OTR/L

Halloween is right around the corner! Most kids can’t wait to put on their costumes and make their way through the neighborhood. No child wants to be left out of the fun of trick or treating or holiday parties. Unfortunately for some children this often happen.s However, with some planning and preparation, children with sensory issues or other special needs, don’t have to be left out and can enjoy this exciting time of year.

General Tips

• Create a schedule for special activities. Tailor the schedule to your child’s needs. Whether it’s a picture schedule or written schedule, using a schedule will help your child be able to anticipate what is coming up and feel calmer. Discuss the schedule regularly and provide information for each transition. Sometimes just knowing what’s next can help children with extra needs feel less anxiety.
• Try using a social story that includes a pictures for your children to help visualize the day and better predict what will happen. You can click here for some sample stories.
• Try having a code word your child can use if he or she feels overwhelmed and needs a break. When your child uses the code word, help them leave the situation for a few moments and discuss coping skills. Again, giving children some control during activities that may be overstimulating will reduce anxiety and enhance the fun.

Decorations

Decorations like fake cobwebs, scary jack-o-lanterns, hanging ghosts, and mist from fog machines can bother kids with special needs.

• Consider taking your child to explore the Halloween section of a local big-box store. You can help your child get used to the various sounds and sights by pressing the different buttons on the various machines. You can also help them get used to the different sensations by touching the variety of decorations. This can be helpful to figure out which ones to avoid during the festivities.
• If your child doesn’t like the smell or slimy texture of pumpkin insides, there are a ton of different ways to decorate pumpkins. You can use paint or permanent markers and stickers to decorate your pumpkins. Pinterest has a ton of ideas like using playdough, coloring with crayons, or using decorations.

Costume Tips

Costumes can be really tricky for our kids. Remember, costumes don’t have to be expensive to be fun and enjoyable for the holiday. When trying to decide on the just right costume, it is important to think not only about the theme but also about how it will feel, fit, and even smell.

• When you find the just right costume, some kids will benefit from washing it a few times to soften the fabric before wearing it the first time.
• Some children might benefit from practicing wearing their costume before the big deal. This will allow your child to problem solve anything that doesn’t feel comfortable. You should practice walking and sitting while wearing the costume.
• It might be helpful to wear comfortable clothes or pajamas under the costume.
• Don’t overlook simple costume ideas. With pinterest now there are a ton of creative ideas that don’t have to involve store bought costumes. You can involve the whole family with themed costumes (this year my family is doing Rock, Paper, Scissors with our regular clothes and few adaptations).
• For trick-or-treaters who use a wheelchair or need help walking long distances, you can get creative and decorate their equipment or wagon.
• For parents who want help in designing or making costumes, there are several resources in bookstores and on the web. Some sites, such as Family Education, provide costume making instructions. Also, organizations, such as the Muscular Dystrophy Association (MDA) and The Bridge School, offer tips and examples of costume ideas. Charities, like Costumes for Kids, collects used costumes and offers them to physically disabled kids too.

Trick or Treating Tips

Trick-or-treating can also be hard. Noisy crowds of kids and flashing decorations. Walking around the neighborhood. Walking at doors. Talking to unfamiliar people. Food sensitivities. Food allergies.

• Do you know about the teal pumpkin? The Teal Pumpkin Project encourages people to raise awareness of food allergies and promotes inclusion of all children by offering an alternative treat for whom candy is not an option.
• Go out at dusk or before the streets get very dark and crowded.
• Only treat or trick at houses you know.
• Map out and practice the route with your child ahead of time so it feels familiar.
• Pull your child in a wagon or let your older child ride a bike to avoid having other kids crowd/bump into him or her.
• Program a special Halloween message into a communication device for kids who need help with language.
• Have some favorite calm down activities or toys ready in case it gets too much for your child.

Please comment below with any suggestions or strategies that have worked well for you. For more information on Occupational Therapy at Easterseals DuPage & Fox Valley and helping children with sensory needs visit: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/occupational-therapy.html. 

 

Back to School Organization

By: Laura Van Zandt, MS, OTR/L

With many of our children returning back to school, I thought this would be a good time to review some strategies to help with school organization. Kids need organization skills in order to function during their school day as well as to get their homework done efficiently at home. If your child struggles with a messy desk, overstuffed backpack, keeping homework and classroom assignments organized, or lost and missing parent/teacher communication slips then hopefully you can find some tips and tricks in this blog. Remember every child is different and what works well for you or another child may not necessarily work well for your own child.

• Most importantly develop routines and stick to them as closely as possible. Some children might benefit from additional support to help learn the routine such as checklists, picture schedules, and/or social stories. Younger children might also benefit from turning the routine into a fun song.
• Create backpack organization systems. Look for backpacks that offer multiple compartments to denote separate spaces. A backpack with at least two compartments is highly recommended. Use a zippered pouch (clear is the best) for pencils, erasers, calculators, etc. in the backpack.
  1. Please check out my previous post on backpack safety.
• Place a laminated checklist clipped to your child’s backpack zipper that lists what needs to be brought home each day. This one from Understood.org is great. 
• Go through the backpack on a regular basis with your child until he/she gets the hang of keeping it organized. Gradually give your child more responsibility and continue to check in even when you have turned in all the responsibility to your child.
• Create a simple schoolwork folder system. A simple 2 pocket folder often works best. Use a bright sticker to place on one side for “KEEP AT HOME” and another bright sticker for the opposite pocket for “BRING BACK”. If your children are older, you can create a color coded system that corresponds to each class. Books and notebooks can use prefabricated book covers or you can use colored paper to create book covers in a variety of colors.

Picture from caffeinatedconclusions.blogspot

• Depending on the age of your child you might start to create a really good binder system. The best ones have a locking rig. Some binders have a clear plastic cover which can be used to create large labels on the outside for different subjects (if you are using a different binder for each subject) or you can use it to hold assignment sheets.
  1. If you are going to start a binder system, then you should invest in a few more organization assistants. Things like subject dividers, a zippered pencil pouch, sheet protectors, two pocket three-hold punched folders, and a portable three-hold punch are really helpful. You can organize each subject section the same. Label each subject divider tab and then include an empty sheet protector immediately behind for important handouts. Behind the sheet protector you can include a folder which follows the same simple schoolwork folder system idea above.
  2. A different option could also be to continue to use the subject divers, zippered pencil pouch, sheet protectors, two pocket three-hold punched folders, and a portable three-hold punch; however, instead of using the simple schoolwork folder system idea above with the two pocket folders, you can create one global folder that is in front of the binder where your child put homework for each class in front. At the end of the day, when at home, you can then sit with your child and help organize their homework when completed back into each individual subject folder.

• Some children might do also better with an accordion file based system. One suggestion for organized would be using the front section to keep your child’s homework planner or global two-pocket folder homework folder. Each additional pocket would be labelled with the different subjects and might include a separate pad of paper for that subject. I like to avoid loose sheets of paper as much as possible with an accordion system as I find they tend to slide down.
• Create an organization system for lockers. Some children like to create a container system where they use separate containers for different belongings which are labeled with pictures on the outside to know what goes inside each bin. You can also add a picture to the locker for a visual cue for where each item belongs which the locker to further help keep things organized. Shelves are also helpful to better divide the space.
  1. To help you and your child determine the most logical and efficient way to organize the locker and backpack, here are some helpful questions (source: The Organized Student)
  2. What is your child’s schedule like? If the schedule is consistent, you can probably just separate the locker into two sections, morning and afternoon. If it changes every day, you might want to organize differently
  3. What extracurricular activities does your child participate in and what supplies/equipment is needed?
  4. Does your child keep supplies and equipment in a locker at school or do they travel back/forth between school and home on a regular basis?
  5. How many books is your child required to keep track of throughout the day
  6. Does your child’s school offer a second set of textbooks on loan?
  7. What type of storage and accessories does the locker already contain?
  8. Does your child have time to go back to his/her locker between classes?

 

• Create a homework station at home. Include all necessary school supplies such as pencils, pens, crayons, markers, glue, scissors, paper, etc. You can use everyday items (mason jars, muffin tin) to help organize items. Containers available at any office/home good are great ways to help organize. You can attach labels made from a label marker or also just use post-its and adhere using clear tape. Every item has its own place and it is easy to spot. Ask your child’s school if it is possible to get a second set of textbooks to eliminate the need to bring books back and forth between school and home. Mark off spaces for items like books and pencil box using painter’s tape. If your child is older, you might think about creating a “desktop file box” which is described in a lot more detailed in The Organized Student book.

 

• Help your child learn to breakdown assignments into manageable chunks. One example includes folding worksheets into sections that can be completed before moving onto the next section.
• Invest in some telling time systems. It is often helpful to breakdown into the concept of telling time, daily time, weekly time, and monthly time. I prefer to use analog’s watches or timers for this as you can see the passage of time which is missing from digital systems. When first learning to tell time and gauge time, create from fun activities to experiment with by guessing how long it will take and then compare guess to actual. It might be useful to have several timers. One for the global amount of time your child/you think he/she needs to complete the assignments and an individual one to break down individual assignments into manageable chunks and to add a spot for a quick break. If you can find an analog clock that also allows for a quick glance to see the time digitally, that might also help.
• Finally, if you have read any of our previous posts on executive functions or attended our executive function client group, then you might be familiar with the group Cognitive Connections. They developed an app that allows users to create a time marker to get ready for work, a timer marker to check in during work, and a marker when the work is planned to end. There are tones activities when the time reaches each marker. This could also be a good choice for some children.
• The key to any organization system is be flexible to your child’s unique organizational style and needs as well as be consistent and offer check-ins until your child has mastered the system. Even when your child has mastered the system, continue to offer periodic support.References and Helpful Resources:
  • Smart But Scattered: The Revolutionary “Executive Skills” Approach to Helping Kids Reach Their Intentional by Peg Dawson and Richard Guare
  • Organizing the Disorganized Child: Simple Strategies to Succeed in School by Martin L. Kutscher M.D. and Marcella Morgan
  • The Organized Student: Teaching Children the Skills for Success in School and Beyond by Donna Goldberg
  • Get Organized Without Losing It by Janet S. Fox
  • The Sensory Child Gets Organized: Proven Systems for Rigid, Anxious, or Distracted Kids by Carolyn Dalgliesh

Routines and Why They Can Help

By: Laura Van Zandt, MS, OTR/L

Routines are very important for all children, but they can be particularly important for children with developmental delays. Routines help provide a sense of certainty and security for children by offering them a predictable pattern that allows them to know what to expect, which will result in less frustration as well as fewer tantrums or meltdowns.

Certain routines are almost universal, such as morning and bedtime routines, but others may exist for specific circumstances or stages of life, such as your family’s weekend morning or school or summer routine.

A great place to start a routine is having a set bedtime. The American Academy of Pediatrics recommends that children ages 3-5 should get 10-13 hours of sleep a day (including naps) and children ages 6-12 should get 9-12 hours of sleep each night. The benefits of getting enough sleep are numerous and include mental/physical health, attention, memory, learning, behavior, and more. The AAP also recommends no screen time 30 minutes prior to bed, no electronics in children’s bedrooms, and having a set bedtime routine.

Setting up a bedtime routine:

Photo from Take Three Photography

Bedtime routines can be anything you want them to be, as long as they are familiar and predictable. For my infant son, he takes a bath every other day. After his bath (or mom and dad quiet playtime on non-bath days), he gets a nice massage and we read a couple goodnight books. When he shows us signs of being tired, we turn off the bedside lamp, swaddle, and turn on the white noise machine.

This routine is something I hope to keep as he gets older. For an older child, you can do a similar routine but you will need to add in time for personal hygiene and perhaps next day activities such as pick out your clothes, pack your backpack, etc. You can use a similar routine for naps, except they would just be shorter.

Aside from bedtime, morning routines, can also be beneficial. Some families have different weekday and weekend morning routines, but other children may need to have one routine that stays the same regardless of the day.

Mealtime can also present an important routine. An easy place to start is to try to have meals around the same time each day. I know this isn’t always possible- but getting as close to a specific time each day can be beneficial and having everyone sit together to eat.

Additionally, having chores to do in family routines helps children develop a sense of responsibility and some basic skills, like the ability to manage time. These are skills children can use for later in life that you can begin at a young age. One great example is singing the “clean up” song when it’s time to finish an activity and move onto something different.

“Clean up clean up
everybody everywhere.
Clean up clean up
everybody do your share.

Clean up clean up
everybody everywhere.
Clean up clean up
everybody do your share.”

Routines can also be great for teaching personal hygiene. Ever heard a parent sing the ABC song while their child washes their hands? This is just one great example.

Here are some tips if you are looking to introduce routines into your daily life:

1. Only change one part of the day at a time.

2. Come up with your basic non-negotiables and then give your children some                    choices (bedtime stories together or separate?).

3. Make a poster with the routine, including photos in the right order, to allow for              self-monitoring. In a good routine, everyone understands their roles, knows what              they need to do and sees their roles as reasonable and fair.

4. Follow the same routine every single day for at least one month, after which it will         become habit and your older kids should be able to keep themselves on schedule for         the easy routines.

Establishing routines has lots of great benefits that can help both you and your child develop scheduling abilities, and increase the likelihood that your family will have a smooth day.

For more information on Easterseals DuPage & Fox Valley, visit eastersealsdfvr.org. 

Through my Parenting Eyes

By: Theresa Forthofer, CEO & President of Easter Seals DuPage & Fox Valley

While I am the President and CEO of Easter Seals DuPage & Fox Valley, I also happen to be the mother of three children.  Two of my children have Myotonic Muscular Dystrophy and Autism. My oldest, Ryan, was diagnosed when he was 7 years old.  He is now 24 years old. My youngest was diagnosed with the Congenital form of Muscular Dystrophy within days of his birth and he is now 18.

Having two boys with Muscular Dystrophy, meant lots of doctor visits and hours of therapy every week.  Throughout the years we had several different therapists and we liked them all.  They were all very nice and the boys were making progress.  Therefore, we assumed everything was great and the boys were doing the best they could.  Looking back, I sincerely wish I knew then, what I know now.  While they were progressing, they were not reaching their full potential.

I may be biased, but what I have learned since becoming President and CEO isn’t as significant as what I have learned about raising two boys with disabilities.  I share my story to help at least one other family find their child’s true potential.

For nearly 7 years, my son had (unsuccessfully) worked on putting his shoes and socks on independently.  His Early Intervention therapist worked on it, his private therapists from a nearby clinic worked on it, and his school therapists worked on it.  Over and over again we were told, he doesn’t have the strength.

Photo by Alexi Procopos

However, when I came to Easter Seals, I asked about Occupational Therapy for Justin.  I wanted him to put his shoes and socks on independently.  In just two sessions, his therapist asked me what our next goal was because he was putting his shoes and socks on independently.  I didn’t believe her and made her show me.  He did it and is still doing it!  His therapist explained it was a motor planning issue not a strength issue for Justin.  For years, I dreaded leaving the house because putting his shoes and socks on became something to battle over. Now those days are long behind us.  No more excuses for being late!

Occupational therapy worked so well, I signed Justin up for the feeding clinic.  At 12 years old, he weighed 40 pounds and we had tried everything.  We saw an endocrinologist, feeding therapists, nutritionists, etc.  The best solution was growth hormones, but Myotonic Dystrophy has cardiac complications, so this was not advised.

After attending the feeding clinic and starting a few relatively small changes, he gained 10 pounds in three months – 25% of his body weight!  He will likely always be small for his age, but we wish it hadn’t taken us so long to figure out these needs and find the experts at Easter Seals.  They imagined a future beyond what we had been told to expect by other professionals and without any limitations.

I hear these same stories like mine, nearly every week.  Children who have been seen for years and aren’t reaching their fullest potential.  When they find their way to Easter Seals DuPage & Fox Valley they often can’t believe what they have missed out on.  The progress their children are making so quickly surprises their families, their doctors and sometimes even us.

If you are looking for a therapy center or therapist for your child, here are the top 10 questions to ask:

1. Is the center CARF Accredited and have a Medical Advisory Board?
2. Is the center directly affiliated with any major research hospital systems?
3. Who are your primary referral sources?
4. What are the published results of your satisfaction survey and where can I find them?
5. Is the therapist NDT (Neuro-Developmental Treatment) trained?
6. What diagnoses has the therapist personally treated?
7. What is the average level of experience of the therapists at the center?
8. How many children do you treat annually?
9. What training do you receive on a regular basis?
10. How do you support parents and siblings?

As parents, we all want the absolute best for our kids. I found it here at Easter Seals and you can too!

Easter Seals DuPage & Fox Valley is a CARF accredited facility with a medical advisory board and affiliations with University of Chicago, University of Illinois at Chicago, Northwestern University and RIC (Shirley Ryan Ability Lab). With 87 therapists and professional staff with an average tenure of 19 years, the majority of therapists are NDT trained and are required to receive on-going training. The therapists are specialized in many specific areas including feeding, motor, sensory needs and more.

Easter Seals serves more than 1,000 families a week with locations in Naperville, Villa Park and Elgin.  Through an annual client survey, 99% of families report satisfaction with the services they receive and 98% of families report progress. The parent liaisons and social workers on staff provide support and family activities for all members of the family. Learn more at eastersealsdfvr.org.