Well school’s out and many kids that have sensory modulation difficulties or self-regulation difficulties may have a hard time dealing with the change in their routine and schedule, so parents…this episode is to help you set up your summer schedule so your child’s emotions can stay in check.

Children who have problems with transitions and changes in plans and routines are our dyspraxic kids. These kids find comfort in routines, to the point that a lack of structure and routine can make or break their day. They can thrive on structure down to the foods they eat, the way they eat them, the color of the utensils they use, the way they play with certain toys, the rules they establish during play or self-care routines, the TV shows they watch and the way they complete their morning and bedtime routines (usually in a very rigid and inflexible way). In order for them to be less rigid they need to have better processing in their brain stem, which means their nervous system can’t have any traffic jams or lose any important information when it’s in transit to the brain.

These kids are rigid in their thinking and easily stressed and reactive. So, how are we going to keep their nervous systems calm and their bodies happy so that summer is enjoyable for the whole family?

We need to establish routines to provide a highly structured day for these children who thrive on structure. These are the kids that do better in school due to the structure and then have a difficult time regulating their arousal on the weekends when there is less structure and predictability, and sometimes more “down time”.
Times of the day to structure include:

• a morning wake up time & wake up routine
• physical activities and outlets several times per day
• learning times (this can be anything from simple to rigorous depending on the child, the age and the goals that need to be achieved before the start of the new school year)
• quiet/relaxation time
• meal times (try to keep these at a consistent time)
• an established bed time & bedtime routine

Tips for vacations include:

• try to keep the same structure as outlined above (especially sleep/wake and meal times)
• plan ahead (have opportunities for movement, quiet time, a change of clothes, chewing objects, etc…to prevent meltdowns based on what makes your child’s nervous system stressed)
• build breaks into your day to prevent over-stimulation or over-tiredness
• set aside quiet time opportunities (away from other siblings, away from the busy areas in theme parks, etc…)
• setup a schedule for your child to refer to throughout the trip or for each day if your vacation is packed with a lot of activities in one day, this schedule can be a group of pictures, words or a written outline for those who are good readers

Your Discipline Style:

It’s always best as a parent, babysitter, teacher, therapist or other professional to be firm, forgiving and consistent when helping a child manage his emotions and actions. Children may not appreciate you being firm and setting boundaries, but they ultimately thrive on the structure that your rules and boundaries provide.

Foods Recommended: yes, we are what we eat, so get your child to eat as healthy as possible, which often includes the following:

• a high protein diet
• low sugar foods
• organic when possible, especially for meat, milk (if any at all), grains and porous fruits that can easily absorb pesticides when they are growing.

Sometimes you will want to give your children the same, fun experiences that you had as a child, and you may relate your summer vacations to foods like ice cream on the boardwalk or cotton candy at a baseball game, but you really need to look at the best interest of your sensitive child. He or she will have equally fond memories of their childhood if you provide safe and fun activities for them. The most important thing to them is truly your time and attention.

Please pass this on to your parents and extended family members as well, so the grandparents and relatives aren’t sabotaging your great ideas, plans and efforts. You can have a more gentle summer if your family is all on the same page! Enjoy!

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Great big thanks to Amy for returning this week to share more information on her family’s journey to help Christopher. Last week Amy talked about Christopher’s symptoms that were most frustrating and challenging to him and others. She reported good improvements from previous cognitive behavioral therapy along with the new addition of Neurofeedback. After 20 sessions of Neurofeedback, Amy reported amazing changes in her son, which include:

• being more compliant
• being able to reason with adults much better
• being much less reactive and having less tantrums
• being able to fall asleep on his own, when his Mom is nearby versus in his room with him

From a sensory modulation perspective, Christopher needs an intense physical outlet each day in order to help keep his nervous system better balanced. He thrives on the fact that he has P.E. in school every day, and relies on this time to help him make his body feel better. He also makes time for physical activity at home on a frequent, if not daily basis and his parents are very supportive. Therefore, physical activity would never be taken away from him as a form of punishment. It’s a “given” in his household.

Amy’s next exciting venture is to jump into the world of alternative health and make some dietary changes. She is reading the book by Sheila Rogers, called “Natural Treatments for Tics & Tourette’s” which is serving to be an amazing resource book for people with tics, Tourette’s and other conditions such as ADHD.

Amy highlighted some of the book’s recommendations and stated that there’s more to be done than just reducing your child’s sugar intake. Big culprits that add to neurological disorders are food coloring, preservatives and processed sugar. Dietary supplements are showing to be invaluable, and allergies are reported to be a very large part of Tourette’s and Tic Disorders.

Although every child is different in their biological makeup, Amy was willing to share with everyone what Christopher is taking so far which includes: Juice Plus+, and Coromega (an omega 3 fatty acid product which comes in a great tasting chocolate or orange pudding consistency). Christopher’s thinking, anxiety and stress levels all improved within a few weeks of taking these products.

Amy’s tips for struggling parents:

There’s hope!! Although the interventions that have been done may not be a quick fix, you should see good progress. Amy’s family has spent 5 long years trying to help Christopher in any way they can and she feels like they are just scratching the surface. “It’s a lot of work, but it’s worth it” she says, as nothing is better than being able to tell that your child’s body feels better.

Please listen to this episode for more information as Amy is an amazing wealth of knowledge and a true inspiration!

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I had the pleasure of interviewing a very kind and informative parent on the experiences her son and her family have gone through before receiving neurofeedback, and then after 20 sessions of neurofeedback therapy have been completed.

Amy is the mother of my client Christopher who is almost 13. He’s a really nice and down-to-earth 7^th grader who showed symptoms of having Tourette’s and Obsessive Compulsive Disorder around 7-8 years of age. He was highly emotional several times per day and always had difficulty falling asleep or sleeping through the night. He had night terrors until 3 years of age, hated loud noises and didn’t like the dark. He also had trouble focusing on difficult tasks. He was a straight “A” student in elementary school and had a hard time adjusting to transitions to many different teachers and their learning styles in middle school. He’s very friendly and has two very close friends, but because other peers harass him at school, he has a defensive personality and becomes very emotional.

Then he was around 7-8 years old it was thought that he had Generalized Anxiety and he saw a therapist for this. Then he had an obsessive ritual at night that he had to complete, which involved asking the same 6 questions he had in his head, over and over. His tics started with eye blinks and throat clearing, and got worse through puberty (which is expected). He also received Cognitive Behavioral Therapy (Exposure & Response Therapy) and used this approach with the prescribed medication of Zoloft. He also had a phobia related to vomiting and the Zoloft made his stomach upset, so he had to stop taking it. His family then ventured off to find a Neurologist, who informed them that there weren’t very many medications available for children with Tourette’s. Some medications being used for Tourette’s are medications related to blood pressure and Bipolar Disorder.

This is where Amy researched her options and came across Neurofeedback. When her son Christopher started the Neurofeedback program his presenting symptoms were:

• a lot of crying
• a lot of drama & emotions
• temper tantrums
• aggression/defiance
• impulsivity
• poor transitioning.

Amy expects her son’s symptoms to wax and wane with the diagnosis of Tourette’s, but his morning routines are so much more pleasant when getting ready to leave the house and his ability to calm his body down is so much easier for him, after doing a handful of neurofeedback sessions. He is also more remorseful and not so angry.
Amy’s overall list of improvements seen after 20 sessions of Neurofeedback includes:
-being more compliant;
-being able to reason with adults much better;
-being much less reactive and having less tantrums; &
-being able to fall asleep on his own, when his Mom is nearby.
Please tune in next week to hear Amy’s recommendations, thoughts on nutritional/dietary changes needed, and overall advice to help your own child who may have some similarities to Christopher.

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This episode is geared toward parents who are already doing the Therapeutic Listening (ThL) program at home, and want to make sure they have crossed all their T’s and dotted and their I’s. Episode Number 25 from last week was dedicated to defining this program, how it works, and the benefits for your child.

General Guidelines for Implementing the Therapeutic Listening Program:

• This protocol is designed to be used at home during physical activity, for 20-30 minutes each listening time, 2x per day, 7 days per week. There must be a minimum of 3 hours of time separating each listening session (i.e.- first session is done by 9:30am, so the next earliest time it can be done on the same day would be 12:30pm). It’s best to do the listening first thing in the morning before school and then in the late afternoon/early evening (not immediately after school or directly before bed). The CDs need to be changed every 2 weeks, in order to have variety and to receive optimal benefits (as the brain becomes bored and doesn’t take in/benefit from the sound information when it’s so predictable).
• Adults need to place the headphones on their own head before each listening session to check the headphone volume and make sure the sound is coming out of each ear phone (otherwise the cord is likely damaged, or pulled out of the headphones or CD player).
• Turn the CD player on by pressing the “Play” arrow.
• Check the volume, which should be medium to low. You should not be able to hear the music coming out of the headphones on the child’s head when you are 3-4 feet away. You should also be able to talk to others without having to raise your voice or take the headphones off to hear.
• Make sure the sound is coming out of each head phone. If not, check the connection of the cord to the headphones (this can be tricky as it may be pulled out slightly and not noticed initially), then check the connection to the CD player.
• Press the mode button until you have “Rand” for Random or “Shuf” for Shuffle set. Then press the “forward” button to change the track, so the listener is not always listening to track #1 first.
• Press the “Hold” button on the side or back of the CD player to “hold” the shuffle mode and keep the player “on” as kids may bump the player while in motion, turning the player off or changing the settings accidentally (or not so accidentally).
• Place the CD player in the neoprene fanny pack with the cord sticking out of the side, so it’s not bent (otherwise it will be damaged). Put all the extra cord in the fanny pack to get it out of the way.
• Clip the fanny pack to your child’s waist, and adjust it to be snug, so it doesn’t fall off or bump around when the child is in action (walking, jumping, bouncing, climbing, etc…).
• Put the headphones on the child’s head with the cord on the left. The headphones are marked “R” and “L”, but if you remember “cord on the left” then you will know it’s on backwards from across a room, and you can be quick to switch it. This is very important as the music is specially designed to go in a certain ear and up to a certain part of the brain for the desired effects. If the headphones are on the wrong ears, the sound information will not get to its intended destination! Oops!
• Set your timer based on the recommended protocol (never more than 30 minutes at one time). It’s best to have a portable timer. A clip-on kitchen timer is great to clip to your pants pocket so you can make sure your child never listens more than the allotted time.
• Encourage your child to be active, as the music is stimulating, and muscle work can help to clear up traffic jams and make sure the sound information gets to the correct part of the brain for processing.
• If your child is not physically active during the listening times, make sure you know why the therapist is recommending or allowing this, as this is not the intention of this music, nor is it the norm.
• If you child’s behaviors are worse during the listening session or the next few hours after the session, you will need to contact the prescribing therapist, and make adjustments. It’s likely the child needs less time, more physical activity to balance out the intensity of the music, a different CD, and/or a break if congestion, allergies, or an ear infection is present. You can restart the listening after your child has been on medication for an active ear infection for 24 hours. Restart after a flu or illness, when symptoms and the fever have subsided. It’s okay to continue if the child has a cold or allergies, if the program is tolerated under these conditions.
• Keep the Bass Boost turned off at all times, the music is already perfectly recorded, so we don’t want to alter it by increasing the bass.
• If the player is not working after the cord connections are checked, wiggle the cord by the headphones and then by the CD player. If the sound clearly cuts in and out when you wiggle it at either end of the cord, then you need a new cord. These headphones have a warranty for a new cord that you can look in to, otherwise you will need to buy a new one quickly in town (last I heard they are available at Radio Shack for $10). If the headphones are still not working, gently shake them when held in your hands. If you hear one ear piece loudly rattling, then it’s broken. You will have to mail them to the manufacturer and wait a few weeks for them to be fixed or for a replacement. This will really put a kink in your listening program, so be very careful with this equipment.
• Don’t allow the headphones to be used for regular music or by other siblings, as they are too expensive to be using for any other purpose.
• Place all equipment in a mini backpack or a small bag and use this as a designated bag. Don’t allow food, drinks or toys to be put in the same bag for obvious reasons.

Activities That Should Be Discouraged:

• Sedentary activities
• Activities that make the child unavailable such as TV, videos, video games, computer use, homework, sleeping, and/or toys used in a perseverative way (i.e.- lining them up).

Children Under 2 Years of Age:

• They can benefit from this program, but their inner ear is not fully developed yet, so they cannot listen to the CDs with headphones.
• They can listen to the therapeutic CDs using speakers that are equidistant from each other and the child’s ears. The speakers and the child’s ears should form a triangle, which means these speakers need to be quite close to the child’s ears (no more than 3-5 feet away).
• Use a small space such as a bathtub, bathroom or walk in closet (where you and the child can both fit comfortably).

Contraindications:

• Schizophrenia
• Auditory-evoked seizures (meaning it’s known through neurological testing, that your child’s seizures are caused specifically by sounds).

Please keep up on your protocol, be organized and prepared! If you have questions or any challenges, please talk with your child’s therapist. This is an amazing program that can result in huge gains if you can follow through with it. It’s one of the most economical ways to make great developmental gains in therapy, so jump in and you too will get to reap the benefits!

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There are a handful of auditory integration training programs on the market for therapists to use with their clients. Today I am going to talk about the “Therapeutic Listening” program, which is a very well known program in the world of Sensory Integration.

This is a program that was developed by Sheila Frick, from Vital Links, who is an occupational therapist in Madison, Wisconsin. She offers trainings and the purchasing of this specialized equipment to qualified professionals only.

This program involves the use of specialized headphones, that are high quality Sennheiser headphones, that have been altered to provide a therapeutic benefit to the listener. Then there are many CDs to choose from to help meet the therapeutic goals of the client who will be listening to this program. Each CD that’s available addresses the underlying component of sensory processing. Then, each CD has key features that are addressed in addition to sensory processing, which is the core benefit of every CD.

The key features of the CDs address areas such as: social skills, turn taking, sensitivity to sounds, language skills, motor planning, timing, sequencing, organizational skills, coordination, attention, deep breathing, feeling grounding and calm, multisensory processing, the ability to tune into what you are suppose to and tune out background stimulation, improving posture, waking up the body for greater engagement, regulating basic body functions like sleeping, eating and controlling emotions for behavioral control, and the list goes on and on!

Basically, the sound engineers that developed this program, have determined the parts of the brain that need to be stimulated in order to help the listener improve his or her development in that area.

What happens anatomically is the sound waves come into the ear directly from the headphones. This is the purest form of sound which is not distorted for the listener, because the sound waves didn’t get to travel out into open space, like it would if we listened to the music on speakers in a room. Once the sound waves hit the ear, they turn into nerve impulses that send messages to the cochlea in the ear, for hearing. The cool part from here is that the cochlear nerve sends messages to the brainstem from these sound waves, but the vestibular nerve sits on top of the cochlear nerve- they actually share a nerve, which is called the vestibular-cochlear nerve. The vestibular system sits on the inside of each ear, on top of the cochlea, and detects movement from our body. So, when the sound waves vibrate the cochlea for hearing, it has an overflow effect into the vestibular nerve. This sends messages of movement to the brain stem, which in turn satisfies the listener who craves movement! This is how these CDs can help a child have better posture, attention, eye skills, level of alertness, and more. It’s as if a child is moving, jumping and swinging- but they are listening instead! These children still need to be active and moving during their listening times, to further integrate this sensory information, but the power of this listening program in addition to movement and muscle work is amazing! Progress is usually seen within a few sessions and then the child continues to show improvement throughout the course of their listening program.

This program can be done for weeks, or many months, depending on each child’s needs. It’s a great way to increase the intensity of a home program established by your child’s therapist.

The Therapeutic Listening program is listened to using a portable CD player and a neoprene waist band that holds the player close to the body so a child can listen to this program while in motion. Again, this is not a program that encourages a child to sit and listen. It’s trying to activate different parts of the brain and mature the brain stem- where sensory processing occurs, so movement and muscle work activities are a big component of making this program successful.

If you are interested in starting this program, you will need to be committed to having your child listen to this program ideally twice a day for 20-30 minutes each time, every day. There is some wiggle room here, but it does need to be done close to this time frame in order to expect good results. You can talk to your child’s therapist if you have concerns with how well you will be able to follow through.

If you are ready to try this program, you will need to find a trained therapist and work with them to determine the appropriate CDs and equipment for your child. This is not a program you can order online or buy somewhere and try on your own. It is highly specialized equipment that needs to be purchased through an authorized professional. Therefore, you don’t want to borrow this from a friend and just to give it a whirl!

Next week I will go over the specific details of how to make sure your therapeutic listening program is being done properly, which can be a helpful reminder to families who have purchased this program and are ready to start it at home, or to anyone who would like guidance to make sure they are on track.

If you don’t know of a professional in your area, you can find a practitioner online through our website links at www.pediatricpotentials.com, or by going to the Therapeutic Listening company website at www.vitallinks.net.

I hope you can make the time to add this to your busy schedules as an intense and powerful home program addition for your sensory kids, as the children we work with in our office seem to progress toward their goals about twice as fast, if they are doing this program at home, in addition to their weekly therapy sessions in our office. It’s well worth the time and money!

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